| NPI | 1174938773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY JANGULA Administrator 701-493-2477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: ND 8009) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |