Healthcare Provider Details

I. General information

NPI: 1114844248
Provider Name (Legal Business Name): WIN-LIBERIA) WOMEN INITIATIVE NETWORK OF LIBERIA IN CASS & CLAY COUNTIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15TH 21ST STREET SOUTH SUITE 104
FARGO ND
58103
US

IV. Provider business mailing address

15TH 21ST STREET SOUTH SUITE 104
FARGO ND
58103
US

V. Phone/Fax

Practice location:
  • Phone: 701-491-0578
  • Fax:
Mailing address:
  • Phone: 701-491-0578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. PRECIOUS DWEH
Title or Position: CEO/PROGRAM DIRECTOR
Credential:
Phone: 701-491-0578