# TRI-COUNTY RETIREMENT & NURSING

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hatton Prairie Village
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811055197
- **Authorized official:** CYNTHIA L TREDWELL J.D. (ADMINISTRATOR)
- **Authorized official phone:** (701) 543-3531

## Contact information

- **Practice address:** 950 DAKOTA AVE, HATTON, ND 58240
- **Practice address phone:** (701) 543-3102
- **Practice address fax:** (701) 543-4059
- **Mailing address:** 950 DAKOTA AVE, HATTON, ND 58240
- **Mailing address phone:** (701) 543-3102
- **Mailing address fax:** (701) 543-4059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1030A | ND | Yes |

## Other

- **Enumeration date:** 12/05/2006
- **Last updated:** 07/07/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1255 | BLUE CROSS BLUE SHIELD | ND |
| 05 | — | 30018 | — | ND |
| 01 | — | 534320800 | MN MEDICAID | MN |