Healthcare Provider Details

I. General information

NPI: 1922751452
Provider Name (Legal Business Name): REHABILITATION HOSPITAL OF GRAND FORKS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 S WASHINGTON ST STE B
GRAND FORKS ND
58201-7217
US

IV. Provider business mailing address

4500 S WASHINGTON ST STE B
GRAND FORKS ND
58201-7217
US

V. Phone/Fax

Practice location:
  • Phone: 701-732-7400
  • Fax: 701-732-7499
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: CAREY BENNETT MCRAE
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 205-970-3442