Healthcare Provider Details

I. General information

NPI: 1861694796
Provider Name (Legal Business Name): GOLDEN VALLEY BILLINGS MULTI-COUNTY SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 FIRST STREET SE BOX 279
BEACH ND
58621-0279
US

IV. Provider business mailing address

67 FIRST STREET SE BOX 279
BEACH ND
58621-0279
US

V. Phone/Fax

Practice location:
  • Phone: 701-872-4121
  • Fax: 701-872-3141
Mailing address:
  • Phone: 701-872-4121
  • Fax: 701-872-3141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number38817
License Number StateND

VIII. Authorized Official

Name: MR. RICHARD FEDJE
Title or Position: DIRECTOR
Credential:
Phone: 701-872-4121