# MARIAN MANOR COMMUNITY CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Marian Manor Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316948631
- **Authorized official:** MS. SANDRA F GERVING (ADMINISTRATOR)
- **Authorized official phone:** (701) 348-3107

## Contact information

- **Practice address:** 604 E ASH AVE, GLEN ULLIN, ND 58631-7138
- **Practice address phone:** (701) 348-3107
- **Mailing address:** PO BOX 578, GLEN ULLIN, ND 58631-0578
- **Mailing address phone:** (701) 348-3107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1025A | ND | Yes |

## Other

- **Enumeration date:** 08/09/2005
- **Last updated:** 12/17/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30067 | — | ND |