Organization Active NPI

Supportive Outreach Services

  • Case Management Agency
  • Bismarck, ND
National Provider Identifier
1578322293
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SUPPORTIVE OUTREACH SERVICES
Practice address
3333 E Broadway Ave Ste 1214
Bismarck, ND 58501-3395
Phone
(701) 226-0621
NPI assigned
Mar 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vernelle Spencer
Title
LMSW/Owner
Phone
(701) 226-0621

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

3333 E Broadway Ave Ste 1214
Bismarck, ND 58501-3395

Mailing address

3333 E Broadway Ave Ste 1214
Bismarck, ND 58501-3395

National Provider Directory

National Provider Directory

Locations

3333 E Broadway Ave
Ste 1214
Bismarck, ND 58501
Phone (701) 226-0621

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1578322293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E BROADWAY AVE STE 1214",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 E BROADWAY AVE STE 1214",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013395",
            "telephone_number": "701-226-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE OUTREACH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "VERNELLE",
        "authorized_official_title_or_position": "LMSW/OWNER",
        "authorized_official_telephone_number": "701-226-0621"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.