| NPI | 1811039316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN LEE DECOTEAU Administrator 701-244-5495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: ND 1016A) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2025-01-13 |