Organization
BAPTIST HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEELOCHANI STADTHERR (SENIOR DIRECTOR OF REIMBURSEMENT)
(952) 855-5041
Entity
Organization
Contact information
Practice address
3400 NEBRASKA DR, BISMARCK, ND 58503
(701) 223-3040
(701) 223-3053
Mailing address
3400 NEBRASKA DR, BISMARCK, ND 58503-1649
(701) 223-3040
(701) 223-3053
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
8003A
ND
314000000X
Skilled Nursing Facility
Primary
1003A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030003
—
ND
05
—
030728
—
ND
01
—
1321
BLUE CROSS BLUE SHIELD
ND
Enumeration date
03/14/2006
Last updated
04/06/2023
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