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Organization

DAKOTA SPECIALTY INSTITUTE

Active
Other names
Innovis Health
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PETRICE BALKAN (VP PRACTICE MANAGEMENT/MANAGED CARE)
(701) 364-6202
Entity
Organization

Contact information

Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8051
(701) 364-8078
Mailing address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8051
(701) 364-8479

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
5067A
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01440
ND
01
058G0IN
MINNESOTA BLUE CROSS BLUE
MN
01
12195
BLUECROSS BLUESHIELD OF N
ND
01
1B02HIN
MINNESOTA BLUECROSS BLUES
MN
05
948155900
ND
Enumeration date
10/04/2005
Last updated
06/27/2008
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