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General NPI Number Information
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NPI Number | 1750234753
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Entity Type | Organization
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Legal Business Name | BETHS PLACE MEDICATION MANAGEMENT LLC
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 1606 30TH AVE S
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City | MOORHEAD
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State | MN
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Zip | 56560-5147
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Country | US
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Telephone | 701-566-9965
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Fax | 218-600-5488
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Provider Business Mailing Address
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Address Line | 1606 30TH AVE S
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City | MOORHEAD
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State | MN
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Zip | 56560-5147
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Country | US
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Telephone | 701-566-9965
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Fax | 218-600-5488
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Authorized Official
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Title or Position | CEO
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Name | CASSIE KASOWSKI
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Credential | M.S. LAC, LADC
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Telephone | 701-936-1190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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