Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
EVENTIDE
Active
Organization
EVENTIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WADE E STUBSON (CFO)
(218) 291-2216
Entity
Organization
Contact information
Practice address
1405 7TH ST S, MOORHEAD, MN 56560-3444
(218) 233-7508
(218) 233-3602
Mailing address
1405 7TH ST S, MOORHEAD, MN 56560-3444
(218) 233-7508
(218) 233-3602
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
332819
MN
314000000X
Skilled Nursing Facility
00072
MN
Other
Enumeration date
01/15/2007
Last updated
09/11/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up