Healthcare Provider Details

I. General information

NPI: 1164336541
Provider Name (Legal Business Name): CHRISTOPHER ST.CLAIRE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 MAIN AVE E
ROLLA ND
58367-7400
US

IV. Provider business mailing address

809 MAIN AVE E
ROLLA ND
58367-7400
US

V. Phone/Fax

Practice location:
  • Phone: 701-578-5672
  • Fax:
Mailing address:
  • Phone: 701-578-5672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: