Dakota Boys Ranch Fargo Youth Home

LBN: Dakota Boys & Girls Ranch Assocation
Dakota Boys Ranch Fargo Youth Home is an health care organization with primary practice located at 6301 19Th Ave Nw , Minot ND 58703. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Dakota Boys & Girls Ranch Assocation can be contacted via phone (701) 858-0115, or through Gantzer, Shondell via phone (701) 858-0115.

Contact Information

Primary practice address
6301 19Th Ave Nw Minot ND 58703
Phone: (701) 858-0115
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gantzer, Shondell
Phone: (701) 858-0115

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X North Dakota

Profile Details

NPI number 1831271808
LBN Legal business name Dakota Boys & Girls Ranch Assocation
DBA Doing business as Dakota Boys Ranch Fargo Youth Home
Authorized official Gantzer, Shondell
Entity Organization
Organization subpart 1 No
Enumeration date Oct 19th, 2006
Last updated Nov 1st, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831271808 NPPES
North Dakota Other 244003 BLUE SHIELD
North Dakota MEDICAID 54715 BLUE SHIELD

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