Organization
THE VILLAGE FAMILY SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS VANG (PRESIDENT/CEO)
(701) 451-4900
Entity
Organization
Contact information
Practice address
1401 8TH ST S, MOORHEAD, MN 56560-3605
(701) 451-4855
Mailing address
1201 25TH ST S, PO BOX 9859, FARGO, ND 58103-2311
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
454484600
—
MN
05
—
596357500
—
MN
Enumeration date
03/22/2017
Last updated
11/09/2017
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