Healthcare Provider Details

I. General information

NPI: 1780441808
Provider Name (Legal Business Name): RIVERTON CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 10/16/2026
Certification Date: 10/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 32ND AVE S STE 240
FARGO ND
58103-6118
US

IV. Provider business mailing address

3003 32ND AVE S STE 240
FARGO ND
58103-6118
US

V. Phone/Fax

Practice location:
  • Phone: 701-807-4214
  • Fax:
Mailing address:
  • Phone: 701-807-4214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AHMED SHEIKH-MOHAMED
Title or Position: OWNER
Credential:
Phone: 952-262-9411