| 4th Corporaiton | |
|
1006 2nd Avenue North New Rockford ND 58356 | |
| (701) 947-2147 | |
| Not Available |
| Full Name | 4th Corporaiton |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1006 2nd Avenue North, New Rockford, North Dakota |
| Authorized Official Name and Position | Kodi Keller (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7019472147 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 4th Corporaiton 120 11th Street North New Rockford ND 58356 Ph: (701) 947-2147 | 4th Corporaiton 1006 2nd Avenue North New Rockford ND 58356 Ph: (701) 947-2147 |
| NPI Number | 1114527322 |
|---|---|
| Provider Enumeration Date | 10/27/2020 |
| Last Update Date | 10/27/2020 |
| Certification Date | 10/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114527322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
4th Corporaiton Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 11th Street North, New Rockford, ND 58356 Phone: 701-947-2147 |