Organization
HOME ON THE RANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SZUDERA A.O. (BUSINESS ADMINISTRATION DIRECTOR)
(701) 872-3745
Entity
Organization
Contact information
Practice address
16351 I94, SENTINEL BUTTE, ND 58654-9500
(701) 872-3745
(701) 872-3748
Mailing address
16351 I94, SENTINEL BUTTE, ND 58654-9500
(701) 872-3745
(701) 872-3748
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050603
—
ND
01
—
06887-001
BS OF ND
ND
05
—
1454974
—
ND
05
—
1478591
—
ND
05
—
320399
—
MT
Enumeration date
03/09/2007
Last updated
07/21/2022
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