| Pride Inc | |
|
1200 Missouri Ave Bismarck ND 58504-5264 | |
| (701) 712-5125 | |
| Not Available |
| Full Name | Pride Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1200 Missouri Ave, Bismarck, North Dakota |
| Authorized Official Name and Position | Jamie J Stair Tessness (SENIOR ACCOUNTANT) |
| Authorized Official Contact | 7017125125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pride Inc Po Box 4086 Bismarck ND 58502-4086 Ph: (701) 712-5125 | Pride Inc 1200 Missouri Ave Bismarck ND 58504-5264 Ph: (701) 712-5125 |
| NPI Number | 1477153146 |
|---|---|
| Provider Enumeration Date | 10/30/2020 |
| Last Update Date | 10/30/2020 |
| Certification Date | 10/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477153146 | NPI | - | NPPES |
| 1455755 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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