MEDICARE: ECUMEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	8045	ND

General Provider Information

NPI Number	:	1013386788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECUMEN

Provider Business Mailing Address
First Line	:	3530 LEXINGTON AVE N
Second Line	:
City	:	SHOREVIEW
State	:	MN
Zip	:	55126-8166
Country	:	US
Telephone Number	:	651-766-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 W GATEWAY CIR S
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58103-3529
Country	:	US
Telephone Number	:	701-239-4524
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	DOUGLAS HARRISON
Credential	:
Telephone Number	:	651-766-4300

Provider Enumeration Date	:	09/23/2015
Last Update Date	:	04/22/2026

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Directions to “ECUMEN ” Practice Location

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