4th Corporation

NPI #1750559035 in New Rockford, North Dakota

Provider Information

NPI Number
1750559035
Entity Type
Organization
Organization Name
4th Corporation
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Feb 20, 2008
Last Updated
Feb 20, 2008

Practice Location

Address
120 11TH ST N
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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