Grand Forks Head Start

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

R22445 Issued in ND

Legal business name

GRAND FORKS HEAD START

Practice address

3600 6TH Ave N
Grand Forks, ND 58203-2723

Phone

(701) 746-2433

Fax

(701) 746-2450

NPI assigned

Jul 14, 2014

Organization subpart

No

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

Authorized official

Name

Kristi Raye Holm, RN

Title

Health Coordinator

Phone

(701) 746-2433

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grand Forks Public School Other name

Tax ID family

Grand Forks Public Schools District 14 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Grand Forks Public Schools District 1

  • Local Education Agency (LEA)
  • Grand Forks, ND
  • NPI 1093862393
  NPD tax ID
• Grand Forks Public Schools District 1

  • Local Education Agency (LEA)
  • Grand Forks, ND
  • NPI 1457240129
  NPD tax ID
• Grand Forks Public Schools District 1

  • Local Education Agency (LEA)
  • Grand Forks, ND
  • NPI 1619747151
  NPD tax ID

Locations

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405296000000",
    "number": "1881001618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 6TH AVE N",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582032723",
            "telephone_number": "701-746-2433",
            "fax_number": "701-746-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 6TH AVE N",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582032723",
            "telephone_number": "701-746-2433",
            "fax_number": "701-746-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND FORKS HEAD START",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "RAYE",
        "authorized_official_title_or_position": "HEALTH COORDINATOR",
        "authorized_official_telephone_number": "701-746-2433",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "ND",
            "license": "R22445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59921",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Forks Public School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Grand Forks Clinic Pharmacy
• Grand Forks Counseling and Therapy PLLC
• Grand Forks County Social Services
• Grand Forks Foot and Ankle Clinic, PLLC
• Grand Forks Growth and Support Center
• Grand Forks Public School District
• Grand Forks Public Schools District 1
• Grand Forks Public Schools District 1
• Grand Forks Public Schools District 1
• Grand View LLC

• Early Intervention Provider Agency in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Early Intervention Provider Agency in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.