Healthcare Provider Details

I. General information

NPI: 1477410546
Provider Name (Legal Business Name): FIRST WILLISTON CARE LLCL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 32ND ST E APT 203
WILLISTON ND
58801-5083
US

IV. Provider business mailing address

215 32ND ST E APT 203
WILLISTON ND
58801-5083
US

V. Phone/Fax

Practice location:
  • Phone: 701-770-7793
  • Fax:
Mailing address:
  • Phone: 701-770-7793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOLIE IPONDO AKUMBY
Title or Position: DIRECTOR
Credential:
Phone: 701-770-7793