Organization
PARKSIDE HOME
Active
Other names
Parkside Lutheran Home, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE HENDRICKSON (ADMINISTRATOR)
(701) 683-5239
Entity
Organization
Contact information
Practice address
501 - 3RD AVE WEST, LISBON, ND 58054-0153
(701) 683-5239
(701) 683-4109
Mailing address
501 - 3RD AVE WEST, LISBON, ND 58054-0153
(701) 683-5239
(701) 683-4109
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1081A
ND
Other
Enumeration date
06/09/2005
Last updated
07/10/2007
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