Organization
4000 VALLEY SQUARE INC
Active
Parent organization
VALLEY MEMORIAL HOMES
Other names
WOODSIDE VILLAGE, Valley Senior Living on 42nd, Country Estates, Wheatland Terrace
Organization subpart
Yes
Provider details
NPI number
Legal business name
VALLEY MEMORIAL HOMES
Authorized official
MRS. MEGAN ANDERSON (ADMINISTRATIVE PROJECT COORDINATOR)
(701) 787-7970
Entity
Organization
Contact information
Practice address
4000 24TH AVE S, GRAND FORKS, ND 58201-8863
(701) 787-7500
(701) 787-7822
Mailing address
4000 24TH AVE S, GRAND FORKS, ND 58201-8863
(701) 787-7500
(701) 787-7822
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1077A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03-0201
—
ND
Enumeration date
10/03/2006
Last updated
08/22/2019
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