Organization
FOUR SEASONS HEALTHCARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEDE COOKSON (ADMINISTRATOR)
(701) 724-6211
Entity
Organization
Contact information
Practice address
483 4TH ST SW, FORMAN, ND 58032-4210
(701) 724-6211
(701) 724-3060
Mailing address
483 4TH ST SW, FORMAN, ND 58032-4210
(701) 724-6211
(701) 724-3060
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
8070A
ND
314000000X
Skilled Nursing Facility
Primary
1075B
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30406
—
ND
01
—
30762
BASIC CARE
—
Enumeration date
01/04/2006
Last updated
10/15/2007
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