Healthcare Provider Details

I. General information

NPI: 1487839296
Provider Name (Legal Business Name): ANNE CENTER FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2007
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 3RD ST NW
JAMESTOWN ND
58401-2965
US

IV. Provider business mailing address

701 3RD ST NW
JAMESTOWN ND
58401-2963
US

V. Phone/Fax

Practice location:
  • Phone: 701-252-3850
  • Fax: 701-952-5154
Mailing address:
  • Phone: 701-252-3850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number StateND

VIII. Authorized Official

Name: TIM EISSINGER
Title or Position: CEO
Credential:
Phone: 701-952-5187