Organization
4TH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KODI KELLER (BUSINESS MANAGER)
(701) 947-2147
Entity
Organization
Contact information
Practice address
120 11TH ST N, NEW ROCKFORD, ND 58356-1434
(701) 947-2147
Mailing address
120 11TH ST N, NEW ROCKFORD, ND 58356-1434
(701) 947-2147
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
ND01161
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30809
—
ND
Enumeration date
02/20/2008
Last updated
02/20/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up