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Organization
DICKINSON COUNTRYHOUSE LLC
Active
Organization
DICKINSON COUNTRYHOUSE LLC
Active
Other names
Dickinson CountryHouse LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STACY RANDELS (VP ASSET MANAGEMENT)
(531) 800-3364
Entity
Organization
Contact information
Practice address
628 24TH ST W, DICKINSON, ND 58601-2731
(701) 847-0842
Mailing address
17110 MARCY ST STE LL01, OMAHA, NE 68118-3119
(531) 800-3364
(531) 800-3364
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
NULL
311500000X
Alzheimer Center (Dementia Center)
Primary
—
NULL
Other
Enumeration date
05/12/2025
Last updated
05/23/2025
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