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NPI Code Detail

MEDICARE: VILLAGE FAMILY SERVICE CENTER

MEDICARE: VILLAGE FAMILY SERVICE CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0400XRehabilitation Clinic/Center
2101YM0800XMental Health Counselor
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)316-8-1-95-97ND

General Provider Information

NPI Number : 1568492353
Entity Type Code : Organization
Provider Name (Legal Business Name) : VILLAGE FAMILY SERVICE CENTER
Provider Business Mailing Address
First Line : 2701 12TH AVE S
Second Line :
City : FARGO
State : ND
Zip : 58103-8753
Country : US
Telephone Number : 701-451-4900
Fax Number : 651-925-0057
Provider Business Practice Location Address
First Line : 2701 12TH AVE S
Second Line :
City : FARGO
State : ND
Zip : 58103-8753
Country : US
Telephone Number : 701-451-4900
Fax Number : 651-925-0057
Authorized Official
Title or Position : PRESIDENT/CEO
Name : KELLY OLSON
Credential : LMFT
Telephone Number : 701-451-4900
Provider Enumeration Date : 07/04/2006
Last Update Date : 07/25/2024

Similar Medicare Providers

1174677785 — MRS. PEGGY L STENEHJEM-TITUS M.ED, LAC
Practice Location Address:
2701 12TH AVE S
FARGO, ND
58103-8753
Practice Phone: 701-451-4900
Practice Fax: 651-925-0057
1316121189 — JOHN A LYON LCSW
Practice Location Address:
2701 12TH AVE S
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58103-8753
Practice Phone: 701-451-4900
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1336370667 — JERILYN J FISCHER-ARNOLD LMFT
Practice Location Address:
2701 12TH AVE S
FARGO, ND
58103-8753
Practice Phone: 701-451-4900
Practice Fax: 651-925-0057
1003146861 — RACHEL A BLUMHARDT
Practice Location Address:
2701 12TH AVE S
FARGO, ND
58103-8753
Practice Phone: 701-451-4900
Practice Fax: 651-925-0057
1952679318 — VILLAGE FAMILY SERVICE CENTER
Practice Location Address:
2701 12TH AVE S
FARGO, ND
58103-8753
Practice Phone: 701-293-3384
Practice Fax: 701-293-3384
1386057123 — ADAM PRIEBNOW
Practice Location Address:
2701 12TH AVE S
FARGO, ND
58103-8753
Practice Phone: 701-451-4900
Practice Fax: 651-925-0057

Directions to “VILLAGE FAMILY SERVICE CENTER ” Practice Location

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