Healthcare Provider Details

I. General information

NPI: 1053253393
Provider Name (Legal Business Name): SAMAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2551 72ND AVE S # 361
FARGO ND
58104-7932
US

IV. Provider business mailing address

19 8TH ST S
FARGO ND
58103-1804
US

V. Phone/Fax

Practice location:
  • Phone: 570-856-6827
  • Fax:
Mailing address:
  • Phone: 570-856-6827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MAUREEN W MILLER
Title or Position: CEO
Credential:
Phone: 570-856-6827