Healthcare Provider Details

I. General information

NPI: 1639021108
Provider Name (Legal Business Name): DAKOTA LIFECARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 UNIVERSITY DR N STE 112
FARGO ND
58102-4659
US

IV. Provider business mailing address

112 UNIVERSITY DR N STE 112
FARGO ND
58102-4659
US

V. Phone/Fax

Practice location:
  • Phone: 701-433-2664
  • Fax:
Mailing address:
  • Phone: 701-433-2664
  • 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: JOHN P TARLEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 701-433-2664