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Organization
SANFORD MEDICAL CENTER FARGO
Active
Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Psychology
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA K LECLERC (VP)
(701) 234-6248
Entity
Organization
Contact information
Practice address
1711 UNIVERSITY DR S, FARGO, ND 58103-4939
(701) 461-5600
Mailing address
801 BROADWAY N, FARGO, ND 58122-0605
(701) 461-5600
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
5068A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1466KLU
BCBS OF MN
MN
Enumeration date
06/27/2008
Last updated
11/27/2023
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