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Organization
FARGO MAPLE VIEW LLC
Active
Organization
FARGO MAPLE VIEW LLC
Active
Other names
Maple View Fargo
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHAD MICHAEL OLSON (CFO)
(701) 852-7700
Entity
Organization
Contact information
Practice address
4552 36TH AVE S, FARGO, ND 58104-5211
(701) 478-8655
Mailing address
4552 36TH AVE S, FARGO, ND 58104-5211
(701) 478-8655
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1461620
—
ND
Enumeration date
10/08/2020
Last updated
10/08/2020
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