ND Teen Challengechrist Centered Treatment Program

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

License

11856 Issued in ND

Legal business name

ND TEEN CHALLENGECHRIST CENTERED TREATMENT PROGRAM

Practice address

1406 2ND St NW
Mandan, ND 58554-4904

Phone

(701) 667-2131

Fax

(701) 663-3494

NPI assigned

Jun 4, 2007

Last updated

Aug 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David Rolland Sjostrom

Title

Director of Programming

Phone

(701) 667-2131

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1871795526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 2ND ST NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585544904",
            "telephone_number": "701-667-2131",
            "fax_number": "701-663-3494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 2ND ST NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585544904",
            "telephone_number": "701-667-2131",
            "fax_number": "701-663-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ND TEEN CHALLENGECHRIST CENTERED TREATMENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "SJOSTROM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ROLLAND",
        "authorized_official_title_or_position": "DIRECTOR OF PROGRAMMING",
        "authorized_official_telephone_number": "701-667-2131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "ND",
            "license": "11856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Children's Substance Abuse Rehabilitation Facility in Mandan, ND
• Providers in Mandan, ND by specialty
• Children's Substance Abuse Rehabilitation Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.