# LIGHTHOUSE CHURCH OF FARGO

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

## Provider details

- **NPI number:** 1316531817
- **Authorized official:** MELINDA FAYE SCHNASE (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (701) 212-8626

## Contact information

- **Practice address:** 111 9TH ST S, FARGO, ND 58103-1831
- **Practice address phone:** (701) 212-8626
- **Mailing address:** 21 9TH ST S, FARGO, ND 58103-1830
- **Mailing address phone:** (791) 212-8626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 347C00000X | Private Vehicle | — | NULL | — |

## Other

- **Enumeration date:** 02/24/2021
- **Last updated:** 02/24/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 251B00000X | — | ND |
| 05 | — | 251S00000X | — | ND |
| 05 | — | 347C00000X | — | ND |