Organization
MANOR ST JOSEPH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY JANGULA (ADMINISTRATOR)
(701) 493-2477
Entity
Organization
Contact information
Practice address
404 4TH AVE, EDGELEY, ND 58433-7417
(701) 493-2477
Mailing address
404 4TH AVE, EDGELEY, ND 58433-7417
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
8009
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30709
—
ND
Enumeration date
06/23/2014
Last updated
06/23/2014
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