Otter Tail Wadena Community Action Council

Primary specialty

Non-Surgical Family Planning Clinic/CenterTaxonomy code 261QF0050X

Legal business name

OTTER TAIL WADENA COMMUNITY ACTION COUNCIL

Practice address

200 1St Ave S
Perham, MN 56573-1445

Phone

(218) 346-3612

Fax

(218) 346-3612

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Davis Leino-Mills

Title

Exec. Director

Phone

(218) 385-2900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1831215128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX L",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "565670372",
            "telephone_number": "218-385-2900",
            "fax_number": "218-385-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST AVE S",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565731445",
            "telephone_number": "218-346-3612",
            "fax_number": "218-346-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTER TAIL WADENA COMMUNITY ACTION COUNCIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "LEINO-MILLS",
        "authorized_official_first_name": "DAVIS",
        "authorized_official_title_or_position": "EXEC. DIRECTOR",
        "authorized_official_telephone_number": "218-385-2900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "587053400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Ann Nyhus, SLP
• Kathryn E Obregon, MD
• Aleina Oftedahl, RBT
• Kathryn Rose Olson, OD
• Kayla Ostlund, RBT
• Sarah Abosede Oyesile
• Bridgit Pankonin, LPC
• Vincent Ward Pankonin, D,C,
• Carmen Ann Parks, LADC
• Morgan Parks, DMD

• Non-Surgical Family Planning Clinic/Center in Perham, MN
• Providers in Perham, MN by specialty
• Non-Surgical Family Planning Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.