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Organization

NEW TOWN HEALTH SUPPORT CORPORATION

Active
Other names
Lakeside Community Living Center
Organization subpart
No

Provider details

NPI number
Authorized official
JEANINE ANN URAN (ADMINISTRATOR)
(701) 627-4711
Entity
Organization

Contact information

Practice address
603 1ST STREET NW, NEW TOWN, ND 58763
(701) 627-4711
(701) 627-4013
Mailing address
PO BOX 818, NEW TOWN, ND 58763
(701) 627-4711
(701) 627-4013

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
8088
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
030792
ND
Enumeration date
08/13/2014
Last updated
08/13/2014
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