Organization
VILLAGE FAMILY SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE HAUGEN (VP OF HUMAN RESOURCES)
(701) 451-4900
Entity
Organization
Contact information
Practice address
1201 25TH ST S, FARGO, ND 58103-2311
(701) 451-4900
(701) 451-4891
Mailing address
1201 25TH ST S, FARGO, ND 58103-2311
(701) 451-4900
(701) 451-4891
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1142
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
454484600
—
MN
05
—
54631
—
ND
05
—
57527
—
ND
Enumeration date
03/05/2008
Last updated
01/25/2018
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