St. James' Of North Dakota, LLC
Clinic/Center, Adult Mental Health in Wishek, ND. Organization (NPI-2).
NPI number1891069191
StatusActive
Last updated in NPPESMar 5, 2012
Details
- NPI
- 1891069191
- Entity type
- Organization (NPI-2)
- Legal business name
- St. James' Of North Dakota, LLC
- Organization subpart
- No
- Enumeration date
- Mar 5, 2012
- Last updated
- Mar 5, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | 7174 | ND | Yes |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | 7174 | ND |
Practice location
1007 4th Ave SWishek, ND 58495-7527
Phone 701-751-8008
Mailing address
3120z 25th St S # 344Fargo, ND 58103-5054
Phone 701-751-8008
Authorized official
Emmet Michael Kenney
President/Ceo
7017518008
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