Organization
FRASER, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN MARIE KLINKHAMMER (DIRECTOR OF BUSINESS OPERATIONS)
(701) 232-3301
Entity
Organization
Contact information
Practice address
2902 UNIVERSITY DR S, FARGO, ND 58103-6032
(701) 232-3301
(701) 237-5775
Mailing address
2902 UNIVERSITY DR S, FARGO, ND 58103-6032
(701) 232-3301
(701) 237-5775
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
35004
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35004
ND DHS PROVIDER NUMBER
ND
Enumeration date
05/10/2007
Last updated
10/19/2020
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