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General NPI Number Information
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NPI Number | 1982149241
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Entity Type | Organization
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Legal Business Name | MOORHEAD OPERATIONS LLC
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Dates
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Enumeration Date | 12/22/2016
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 2810 2ND AVE N
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City | MOORHEAD
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State | MN
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Zip | 56560-2511
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Country | US
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Telephone | 218-233-7578
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Fax | 218-233-8307
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Provider Business Mailing Address
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Address Line | 2810 2ND AVE N
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City | MOORHEAD
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State | MN
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Zip | 56560-2511
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Country | US
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Telephone | 218-233-7578
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Fax | 218-233-8307
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EPHRAM LAHASKY
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Credential |
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Telephone | 646-772-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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