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ANNE CARLSEN CENTER

Intermediate Care Mentally Retarded

Jamestown, North Dakota

Provider NPI: 1326172412

Organization Information:
Organization Name:  ANNE CARLSEN CENTER
Organization is Subpart
Authorized Official:  DAN  HOWELL  CEO  701-2523850

Practice Location:
701 3RD ST NW  JAMESTOWN, ND 58401 US
Tel: 701-252-3850  Fax: 701-952-5154

Business Mailing Address:
701 3RD ST NW  JAMESTOWN, ND 58401 US
Tel: 701-252-3850  Fax: 701-952-5154

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
ND

Other Provider Identifiers:

IssuerNumberStateType
30873ND05
727620600MN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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