1386961514 NPI number — PRODUCTIVE ALTERNATIVES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386961514 NPI number — PRODUCTIVE ALTERNATIVES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRODUCTIVE ALTERNATIVES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CRISIS STABILIZATION UNIT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386961514
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1205 N TOWER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FERGUS FALLS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56537-1077
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-998-5630
Provider Business Mailing Address Fax Number:
218-736-2541

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1013 N TOWER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FERGUS FALLS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56537-1052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-998-2525
Provider Business Practice Location Address Fax Number:
218-998-2522
Provider Enumeration Date:
04/28/2010

Additional Information

Authorized Official

Authorized Official Last Name:
NELSON
Authorized Official First Name:
BETH
Authorized Official Middle Name:
L
Authorized Official Title or Position:
SITE TREAMENT DIRECTOR
Authorized Official Telephone Number:
218-998-2525

Provider Taxonomy Codes

  • Taxonomy code: 320800000X , with the licence number:  1054738-1-AFC , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com