Organization
PROVIDENCE HOUSE MINOT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MORGAN LAYNE (EXECUTIVE DIRECTOR)
(701) 828-3300
Entity
Organization
Contact information
Practice address
415 MAIN ST S, MINOT, ND 58701-4414
(701) 838-3300
Mailing address
PO BOX 1286, WATFORD CITY, ND 58854-1286
(701) 838-3300
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
07/26/2024
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