Healthcare Provider Details

I. General information

NPI: 1801907720
Provider Name (Legal Business Name): CITY OF GRAND FORKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 S 4TH ST SUITE N301
GRAND FORKS ND
58201-4715
US

IV. Provider business mailing address

151 S 4TH ST SUITE N301
GRAND FORKS ND
58201-4715
US

V. Phone/Fax

Practice location:
  • Phone: 701-787-8100
  • Fax: 701-787-8145
Mailing address:
  • Phone: 701-787-8100
  • Fax: 701-787-8145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBBIE SWANSON
Title or Position: DIRECTOR
Credential:
Phone: 701-787-8100