Healthcare Provider Details

I. General information

NPI: 1649180282
Provider Name (Legal Business Name): WE ROCK THE SPECTRUM - NORTH DAKOTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3051 25TH ST S STE KJ1
FARGO ND
58103-6102
US

IV. Provider business mailing address

3051 25TH ST S STE KJ1
FARGO ND
58103-6102
US

V. Phone/Fax

Practice location:
  • Phone: 701-532-3210
  • Fax:
Mailing address:
  • Phone: 701-532-3210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: LORIE ANDERSON
Title or Position: OWNER
Credential:
Phone: 218-689-7444