| NPI | 1487658324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE HENDRICKSON Administrator 701-683-5239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: ND 1081A) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2007-07-10 |