Healthcare Provider Details

I. General information

NPI: 1295734366
Provider Name (Legal Business Name): WESTHOPE HOME FOR THE AGED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 3RD ST E
WESTHOPE ND
58793-4118
US

IV. Provider business mailing address

PO BOX 366
WESTHOPE ND
58793-0366
US

V. Phone/Fax

Practice location:
  • Phone: 701-245-6477
  • Fax: 701-245-6490
Mailing address:
  • Phone: 701-245-6477
  • Fax: 701-245-6490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateND

VIII. Authorized Official

Name: DARWIN M LEE
Title or Position: AMINISTRATOR
Credential:
Phone: 701-245-6477