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General NPI Number Information
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NPI Number | 1245678341
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Entity Type | Organization
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Legal Business Name | OSNABROCK COMMUNTIY LIVING CENTER INC.
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 326 RAINBOW RD
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City | OSNABROCK
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State | ND
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Zip | 58269-6901
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Country | US
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Telephone | 701-496-3131
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Fax | 701-496-3133
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Provider Business Mailing Address
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Address Line | 326 RAINBOW RD
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City | OSNABROCK
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State | ND
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Zip | 58269-6901
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Country | US
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Telephone | 701-496-3131
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Fax | 701-496-3133
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KENNETH NELSON
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Credential |
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Telephone | 701-496-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 8096
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License Number State | ND
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