Healthcare Provider Details

I. General information

NPI: 1609714120
Provider Name (Legal Business Name): HARAMBEE CARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 49TH ST S
FARGO ND
58103-7762
US

IV. Provider business mailing address

1750 49TH ST S APT 202
FARGO ND
58103-7763
US

V. Phone/Fax

Practice location:
  • Phone: 701-404-0393
  • Fax:
Mailing address:
  • Phone: 701-404-0393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: HERITIER RUDEHA
Title or Position: MANAGING MEMBER
Credential:
Phone: 701-404-0393