| |
607 Towner Ave, Larimore, ND 58251-4501 | |
(701) 343-6418 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 607 Towner Ave, Larimore, North Dakota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104490622 | NPI | - | NPPES |
1461963 | Medicaid | ND | |
1461598 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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212 S 4th St Ste 200, Grand Forks, ND 58201-4781 Ph: (701) 757-2100 | 607 Towner Ave, Larimore, ND 58251-4501 Ph: (701) 343-6418 |