Eventide Fargo LLC
NPI #1164809562 in Fargo, North Dakota
Provider Information
- NPI Number
- 1164809562
- Entity Type
- Organization
- Organization Name
- Eventide Fargo LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- May 5, 2015
- Last Updated
- Aug 10, 2016
Practice Location
- Address
- 3225 51ST ST S
- City
- Fargo
- State
- North Dakota
- ZIP Code
- 58104-7180
- Phone
- (218) 291-2230
Authorized Official
- Name
- MR. WADE E STUBSON
- Title
- CFO
- Phone
- (218) 291-2216
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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