Healthcare Provider Details

I. General information

NPI: 1518911700
Provider Name (Legal Business Name): MISSOURI SLOPE LUTHERAN CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 HILLVIEW AVE
BISMARCK ND
58501-3056
US

IV. Provider business mailing address

2425 HILLVIEW AVE
BISMARCK ND
58501-3056
US

V. Phone/Fax

Practice location:
  • Phone: 701-223-9407
  • Fax: 701-222-6328
Mailing address:
  • Phone: 701-223-9407
  • Fax: 701-222-6328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number1004A
License Number StateND

VIII. Authorized Official

Name: REIER THOMPSON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 701-223-9407