Organization
MERCY RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY S. MONSON (VP FINANCE/CFO)
(701) 774-7408
Entity
Organization
Contact information
Practice address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7401
(701) 774-4188
Mailing address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7401
(701) 774-4188
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
1022
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1059
—
ND
01
—
3376
BLUE CROSS OF ND
ND
Enumeration date
07/17/2006
Last updated
08/22/2020
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