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Organization
TELLEGACY LLC
Active
Organization
TELLEGACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY CHRISTOPHER HOLLOWAY PHD, MBA (DIRECTOR)
(419) 270-7511
Entity
Organization
Contact information
Practice address
3523 45TH ST S # 164, FARGO, ND 58104-8962
(419) 270-7511
Mailing address
3523 45TH ST S, FARGO, ND 58104-8962
(419) 270-7511
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
261QR1100X
Research Clinic/Center
—
NULL
261QR1300X
Rural Health Clinic/Center
—
NULL
Other
Enumeration date
10/05/2026
Last updated
10/05/2026
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