# FOUR SEASONS HEALTHCARE CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861470429
- **Authorized official:** MRS. DEDE COOKSON (ADMINISTRATOR)
- **Authorized official phone:** (701) 724-6211

## Contact information

- **Practice address:** 483 4TH ST SW, FORMAN, ND 58032-4210
- **Practice address phone:** (701) 724-6211
- **Practice address fax:** (701) 724-3060
- **Mailing address:** 483 4TH ST SW, FORMAN, ND 58032-4210
- **Mailing address phone:** (701) 724-6211
- **Mailing address fax:** (701) 724-3060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 8070A | ND | — |
| 314000000X | Skilled Nursing Facility | 1075B | ND | Yes |

## Other

- **Enumeration date:** 01/04/2006
- **Last updated:** 10/15/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30406 | — | ND |
| 01 | — | 30762 | BASIC CARE | — |