Organization
CITY COUNTY HEALTH DISTRICT
Active
Other names
City County Health and Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA J WILL R.N. (ADMINISTRATOR)
(701) 845-8518
Entity
Organization
Contact information
Practice address
415 2ND AVE NE STE 101, VALLEY CITY, ND 58072-3060
(701) 845-8518
(701) 845-8542
Mailing address
415 2ND AVE NE STE 101, VALLEY CITY, ND 58072-3060
(701) 845-8518
(701) 845-8542
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
4030A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1455470
—
ND
01
—
1883
BLUE CROSS/BLUE SHIELD ND
ND
01
—
59-00236
MEDICA
ND
Enumeration date
11/04/2005
Last updated
05/07/2019
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