Organization
FAMILY HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN RENZ-JOHNSON (MANAGER, REVENUE CYCLE)
(701) 271-1494
Entity
Organization
Contact information
Practice address
301 NP AVE N, FARGO, ND 58102-4835
(701) 271-3344
(701) 271-3343
Mailing address
301 NP AVE N, FARGO, ND 58102-4835
(701) 239-2287
(701) 551-7533
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1459654
—
ND
05
—
148216500
—
MN
Enumeration date
11/03/2006
Last updated
04/03/2024
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