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Organization
IGNITING YOUR CHANGE
Active
Organization
IGNITING YOUR CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA DECKERT (OWNER)
(701) 696-9075
Entity
Organization
Contact information
Practice address
1128 WESTRAC DR S STE A, FARGO, ND 58103-8729
(701) 696-9075
Mailing address
1128 WESTRAC DR S STE A, FARGO, ND 58103-8729
(701) 696-9075
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/22/2020
Last updated
02/15/2021
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