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General NPI Number Information
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NPI Number | 1255437315
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Entity Type | Organization
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Legal Business Name | THE FAMILY LINK OF MOORHEAD LLC
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1012 18TH AVE N
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City | MOORHEAD
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State | MN
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Zip | 56560-1449
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Country | US
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Telephone | 218-477-0333
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Fax | 218-477-0098
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Provider Business Mailing Address
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Address Line | 1012 18TH AVE N
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City | MOORHEAD
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State | MN
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Zip | 56560-1449
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Country | US
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Telephone | 218-477-0333
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Fax | 218-477-0098
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Authorized Official
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Title or Position | DIRECTOR/CFO
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Name | MR. ERICK T WIGAND
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Credential |
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Telephone | 218-477-0333
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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 | MN
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Taxonomy #2
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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 | MN
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