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Organization
TRI-COUNTY RETIREMENT & NURSING
Active
Organization
TRI-COUNTY RETIREMENT & NURSING
Active
Other names
Hatton Prairie Village
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA L TREDWELL J.D. (ADMINISTRATOR)
(701) 543-3531
Entity
Organization
Contact information
Practice address
950 DAKOTA AVE, HATTON, ND 58240
(701) 543-3102
(701) 543-4059
Mailing address
950 DAKOTA AVE, HATTON, ND 58240
(701) 543-3102
(701) 543-4059
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1030A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255
BLUE CROSS BLUE SHIELD
ND
05
—
30018
—
ND
01
—
534320800
MN MEDICAID
MN
Enumeration date
12/05/2006
Last updated
07/07/2015
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