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Organization

WAY OF LIFE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHEYENNE PUETZ (OWNER)
(701) 581-5199
Entity
Organization

Contact information

Practice address
222 4TH ST N, FARGO, ND 58102-4818
(701) 581-5199
Mailing address
1709 13TH AVE S, FARGO, ND 58103-3812

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
12/08/2023
Last updated
12/26/2023
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