# NORTHWOOD DEACONESS HEALTH CENTER

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

## Provider details

- **NPI number:** 1063401867
- **Authorized official:** PETE L ANTONSON CPA (CEO)
- **Authorized official phone:** (701) 587-6459

## Contact information

- **Practice address:** 4 N PARK ST, NORTHWOOD, ND 58267-4102
- **Practice address phone:** (701) 587-6459
- **Practice address fax:** (701) 587-6479
- **Mailing address:** PO BOX 190, 4 N. PARK ST., NORTHWOOD, ND 58267-0190
- **Mailing address phone:** (701) 587-6459
- **Mailing address fax:** (701) 587-6479

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1045A | ND | Yes |

## Other

- **Enumeration date:** 10/14/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30031 | — | ND |