# FARGO MAPLE VIEW LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maple View Fargo
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922605310
- **Authorized official:** MR. CHAD MICHAEL OLSON (CFO)
- **Authorized official phone:** (701) 852-7700

## Contact information

- **Practice address:** 4552 36TH AVE S, FARGO, ND 58104-5211
- **Practice address phone:** (701) 478-8655
- **Mailing address:** 4552 36TH AVE S, FARGO, ND 58104-5211
- **Mailing address phone:** (701) 478-8655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | — | NULL | Yes |

## Other

- **Enumeration date:** 10/08/2020
- **Last updated:** 10/08/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1461620 | — | ND |