4th Corporaiton
NPI #1114527322 in New Rockford, North Dakota
Provider Information
- NPI Number
- 1114527322
- Entity Type
- Organization
- Organization Name
- 4th Corporaiton
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Oct 27, 2020
- Last Updated
- Oct 27, 2020
Practice Location
- Address
- 1006 2ND AVENUE NORTH
- City
- New Rockford
- State
- North Dakota
- ZIP Code
- 58356
- Phone
- (701) 947-2147
Authorized Official
- Name
- KODI KELLER
- Title
- EXECUTIVE DIRECTOR
- Phone
- (701) 947-2147
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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