| Life Skills And Transition Center | |
|
701 W 6th St Grafton ND 58237-1379 | |
| (701) 352-4564 | |
| (701) 352-4376 |
| Full Name | Life Skills And Transition Center |
|---|---|
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
| Location | 701 W 6th St, Grafton, North Dakota |
| Authorized Official Name and Position | Donna Aukland (ASSISTANT CFO - DHS) |
| Authorized Official Contact | 7013284924 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Skills And Transition Center 701 W 6th St Grafton ND 58237-1379 Ph: (701) 352-4564 | Life Skills And Transition Center 701 W 6th St Grafton ND 58237-1379 Ph: (701) 352-4564 |
| NPI Number | 1558427708 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 12/10/2020 |
| Certification Date | 12/10/2020 |
| Medicare PECOS PAC ID | 7113986159 |
|---|---|
| Medicare Enrollment ID | O20041006000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558427708 | NPI | - | NPPES |
| 30806 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 315P00000X | Intermediate Care Facility, Intellectual Disabilities | (* (Not Available)) | Primary |
| Provider Name | Steven M Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851334858 PECOS PAC ID: 1456370766 Enrollment ID: I20051116000397 |
| Provider Name | Kathryn G Rustebakke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750500054 PECOS PAC ID: 3072608462 Enrollment ID: I20071001000075 |
| Provider Name | Mary K Dusek |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003963042 PECOS PAC ID: 3375671738 Enrollment ID: I20100506000242 |
| Provider Name | Jennie Jon Bata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255506929 PECOS PAC ID: 2961678099 Enrollment ID: I20111220000598 |
| Provider Name | Anita Zavalney |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316140270 PECOS PAC ID: 4981835857 Enrollment ID: I20140319000565 |
| Provider Name | Katie A Stark |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265837991 PECOS PAC ID: 4284958299 Enrollment ID: I20150122002008 |
| Provider Name | Jacy J Whaley |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073038436 PECOS PAC ID: 1658645783 Enrollment ID: I20170927003767 |
| Provider Name | Mckayla Petersen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114454923 PECOS PAC ID: 2365717527 Enrollment ID: I20171013002758 |
| Provider Name | Kelly J Larson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1548301161 PECOS PAC ID: 8224432307 Enrollment ID: I20210811002892 |
| Provider Name | Mohamed Hafad Elhamadany |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124336995 PECOS PAC ID: 1951578293 Enrollment ID: I20220802002681 |
| Provider Name | Tami R Christianson-larson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1558487165 PECOS PAC ID: 8527436468 Enrollment ID: I20221123002611 |
| Provider Name | John B Leclerc |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326513482 PECOS PAC ID: 1557735990 Enrollment ID: I20230324002472 |
| Provider Name | Lindsay A Presteng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134815574 PECOS PAC ID: 7012376122 Enrollment ID: I20230707002237 |
Life Skills And Transition Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 816 W Midway Dr, Grafton, ND 58237 Phone: 701-352-4200 | |
Quinndui/mip/counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 47 West 6th Street, Grafton, ND 58237 Phone: 701-741-3500 Fax: 701-353-0424 | |
Associates & Inhabilitative Planning Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15263 75th St Ne, Grafton, ND 58237 Phone: 701-352-1154 Fax: 701-352-1154 |