Organization
NORTHWOOD DEACONESS HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETE L ANTONSON CPA (CEO)
(701) 587-6459
Entity
Organization
Contact information
Practice address
4 N PARK ST, NORTHWOOD, ND 58267-4102
(701) 587-6459
(701) 587-6479
Mailing address
PO BOX 190, 4 N. PARK ST., NORTHWOOD, ND 58267-0190
(701) 587-6459
(701) 587-6479
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1045A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30031
—
ND
Enumeration date
10/14/2005
Last updated
08/22/2020
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