Organization
ST JAMES OF ND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMET MICHAEL KENNEY JR. M.D. (PRESIDENT)
(701) 361-6640
Entity
Organization
Contact information
Practice address
3000 NORTH 14TH STREET, SUITE 2A, BISMARCK, ND 58503
(701) 361-6640
Mailing address
3120 25TH ST S STE Z, #344, FARGO, ND 58103-6164
(701) 365-4467
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
7174
ND
261QM0855X
Adolescent and Children Mental Health Clinic/Center
7174
ND
Other
Enumeration date
01/06/2011
Last updated
04/03/2013
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