4th Corporaiton
NPI #1740347764 in New Rockford, North Dakota
Provider Information
- NPI Number
- 1740347764
- Entity Type
- Organization
- Organization Name
- 4th Corporaiton
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Jan 2, 2007
- Last Updated
- Feb 15, 2008
Practice Location
- Address
- 120 11TH ST N
- City
- New Rockford
- State
- North Dakota
- ZIP Code
- 58356-1434
- Phone
- (701) 947-2147
Authorized Official
- Name
- KODI KELLER
- Title
- BUSINESS MANAGER
- Phone
- (701) 947-2147
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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