Grand Forks Growth And Support Center | |
2105 Gateway Dr Grand Forks ND 58203-1412 | |
(701) 775-2566 | |
Not Available |
Full Name | Grand Forks Growth And Support Center |
---|---|
Speciality | Community/behavioral Health |
Location | 2105 Gateway Dr, Grand Forks, North Dakota |
Authorized Official Name and Position | Mike Olson (CONTROLLER) |
Authorized Official Contact | 7017752566 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Grand Forks Growth And Support Center 2105 Gateway Dr Grand Forks ND 58203-1412 Ph: (701) 775-2566 | Grand Forks Growth And Support Center 2105 Gateway Dr Grand Forks ND 58203-1412 Ph: (701) 775-2566 |
NPI Number | 1679170179 |
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Provider Enumeration Date | 10/07/2020 |
Last Update Date | 10/07/2020 |
Certification Date | 10/07/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679170179 | NPI | - | NPPES |
1456174 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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