Organization
BETHER 4 ACRES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE KAE WARREN (ADMINISTRATOR)
(701) 320-2649
Entity
Organization
Contact information
Practice address
1404 1ST AVE N, JAMESTOWN, ND 58401-2379
(701) 252-6090
Mailing address
PO BOX 1835, 1404 1ST AVE N, JAMESTOWN, ND 58401
(701) 252-6090
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
8020
ND
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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