Provider Demographics
NPI:1861694796
Name:GOLDEN VALLEY BILLINGS MULTI-COUNTY SOCIAL SERVICES
Entity type:Organization
Organization Name:GOLDEN VALLEY BILLINGS MULTI-COUNTY SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDJE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-872-4121
Mailing Address - Street 1:67 FIRST STREET SE
Mailing Address - Street 2:BOX 279
Mailing Address - City:BEACH
Mailing Address - State:ND
Mailing Address - Zip Code:58621-0279
Mailing Address - Country:US
Mailing Address - Phone:701-872-4121
Mailing Address - Fax:701-872-3141
Practice Address - Street 1:67 FIRST STREET SE
Practice Address - Street 2:BOX 279
Practice Address - City:BEACH
Practice Address - State:ND
Practice Address - Zip Code:58621-0279
Practice Address - Country:US
Practice Address - Phone:701-872-4121
Practice Address - Fax:701-872-3141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND38817251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND038817Medicaid