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RED RIVER HUMAN SERVICES FOUNDATION

Intermediate Care Mentally Retarded

Wahpeton, North Dakota

Provider NPI: 1972626216

Organization Information:
Organization Name:  RED RIVER HUMAN SERVICES FOUNDATION
Organization is not Subpart
Authorized Official:  THOMAS R. NEWBERGER  CEO  701-5323401

Practice Location:
821 WESTERN RD  WAHPETON, ND 58075 US
Tel: 701-235-0971  Fax: 701-235-1051

Business Mailing Address:
2506 35TH AVE S  FARGO, ND 58104 US
Tel: 701-235-0971  Fax: 701-235-1051

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
ND30865

Other Provider Identifiers:

IssuerNumberStateType
003200006ND05
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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