Ebenezer Group Home

LBN: Ebenezer Group Home
Ebenezer Group Home is an health care organization with primary practice located at 1781 35Th St S , Fargo ND 58103-4875. The organization recently has only one registered license in Agencies / In Home Supportive Care, which is considered as the primary health care specialty. Ebenezer Group Home can be contacted via phone (701) 730-7944, or through Travers, Wilton B via phone (701) 730-7944.

Contact Information

Primary practice address
1781 35Th St S Fargo ND 58103-4875
Phone: (701) 730-7944
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Travers, Wilton B BSN
Phone: (701) 730-7944

Health care specialties

SpecialtyCodeLicense #State
Agencies / In Home Supportive Care 253Z00000X

Profile Details

NPI number 1699408443
LBN Legal business name Ebenezer Group Home
DBA Doing business as
Authorized official Travers, Wilton B BSN
Entity Organization
Organization subpart 1 No
Enumeration date Jul 7th, 2022
Last updated Jul 7th, 2022 - about 2 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 1699408443 NPPES
North Dakota MEDICAID 0005876569

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