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General NPI Number Information
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NPI Number | 1114772043
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Entity Type | Organization
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Legal Business Name | KAREPRIDE LLC
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 487 59TH AVE S
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City | GRAND FORKS
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State | ND
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Zip | 58201-8025
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Country | US
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Telephone | 405-408-8574
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Fax |
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Provider Business Mailing Address
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Address Line | 487 59TH AVE S
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City | GRAND FORKS
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State | ND
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Zip | 58201-8025
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PRIDE ABONGWA
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Credential | DR.
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Telephone | 405-408-8574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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