Organization
FAA ADDICTION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHONDELL GANTZER (OFFICE MANAGER)
(701) 857-4232
Entity
Organization
Contact information
Practice address
900 N BROADWAY STE 111, MINOT, ND 58703-2378
(701) 537-4191
(701) 425-0346
Mailing address
900 N BROADWAY STE 111, MINOT, ND 58703-2378
(701) 537-4191
(701) 425-0346
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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