| St. James' Of North Dakota, Llc | |
|
1007 4th Ave S Wishek ND 58495-7527 | |
| (701) 751-8008 | |
| Not Available |
| Full Name | St. James' Of North Dakota, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1007 4th Ave S, Wishek, North Dakota |
| Authorized Official Name and Position | Emmet Michael Kenney (PRESIDENT/CEO) |
| Authorized Official Contact | 7017518008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. James' Of North Dakota, Llc 3120z 25th St S # 344 Fargo ND 58103-5054 Ph: (701) 751-8008 | St. James' Of North Dakota, Llc 1007 4th Ave S Wishek ND 58495-7527 Ph: (701) 751-8008 |
| NPI Number | 1891069191 |
|---|---|
| Provider Enumeration Date | 03/05/2012 |
| Last Update Date | 03/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891069191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 7174 (North Dakota) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 7174 (North Dakota) | Secondary |