Organization
VILLA NAZARETH
Active
Other names
Friendship Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVE KEELER (CFO)
(701) 235-8217
Entity
Organization
Contact information
Practice address
1635 34TH AVE S, FARGO, ND 58104-6123
(701) 280-9750
(701) 232-6021
Mailing address
801 PAGE DR S, FARGO, ND 58103-2315
(701) 235-8217
(701) 235-7538
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
30843
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30843
—
ND
Enumeration date
05/09/2008
Last updated
05/09/2008
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