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Organization

PROVIDENCE HOUSE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MORGAN LAYNE (EXECUTIVE DIRECTOR)
(701) 586-3300
Entity
Organization

Contact information

Practice address
2126 VISTA DR, ARNEGARD, ND 58835
(701) 586-3300
Mailing address
PO BOX 1286, WATFORD CITY, ND 58854-1286

Taxonomy

Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
04/14/2022
Last updated
07/26/2024
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