Organization
DAKOTA BOYS & GIRLS RANCH ASSOCIATION
Active
Other names
Dakota Boys Ranch Fargo RTC
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY MORENO (CREDENTIALING)
(701) 364-2950
Entity
Organization
Contact information
Practice address
7151 15TH ST S, FARGO, ND 58104-6613
(701) 364-2950
Mailing address
7151 15TH ST S, FARGO, ND 58104-6613
(701) 858-0115
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10348
BLUE CROSS
ND
05
—
50521
—
ND
Enumeration date
10/31/2006
Last updated
05/05/2026
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