| NPI | 1861470429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEDE COOKSON Administrator 701-724-6211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: ND 1075B) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: ND 8070A) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2007-10-15 |