# ST. LUKE'S HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023062155
- **Authorized official:** AMY LEANNE KREIDT (CEO/ADMINISTRATOR)
- **Authorized official phone:** (701) 483-5000

## Contact information

- **Practice address:** 242 10TH ST W, DICKINSON, ND 58601
- **Practice address phone:** (701) 483-5000
- **Practice address fax:** (701) 483-5007
- **Mailing address:** 242 10TH ST W, DICKINSON, ND 58601-3926
- **Mailing address phone:** (701) 483-5000
- **Mailing address fax:** (701) 483-5007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1015A | ND | Yes |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 08/10/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1370 | BCBS OF ND | ND |
| 05 | — | 30011 | — | ND |