Organization
BEACON OF LIGHT HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE WOLF (DIRECTOR OF OPERATIONS)
(701) 361-9922
Entity
Organization
Contact information
Practice address
111 9TH ST S, FARGO, ND 58103-1831
(701) 893-8498
Mailing address
111 9TH ST S, FARGO, ND 58103-1831
(701) 893-8498
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
02/18/2025
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