Eventide Fargo

LBN: Eventide Fargo Llc
Eventide Fargo is an health care organization with primary practice located at 3225 51St St S , Fargo ND 58104-7180. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Eventide Fargo Llc can be contacted via phone (218) 291-2230, or through Stubson, Wade E via phone (218) 291-2216.

Contact Information

Primary practice address
3225 51St St S Fargo ND 58104-7180
Phone: (218) 291-2230
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Stubson, Wade E
Phone: (218) 291-2216

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X

Profile Details

NPI number 1164809562
LBN Legal business name Eventide Fargo Llc
DBA Doing business as Eventide Fargo
Authorized official Stubson, Wade E
Entity Organization
Organization subpart 1 No
Enumeration date May 5th, 2015
Last updated Aug 10th, 2016 - about 8 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 1164809562 NPPES
North Dakota MEDICAID 1467362

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