LUTHERAN HOME OF THE GOOD SHEPHERD
Assisted Living Facility
New Rockford, North Dakota
Provider NPI: 1396727004
Organization Information:Organization Name: LUTHERAN HOME OF THE GOOD SHEPHERD
Practice Location:
1226 1ST AVE N NEW ROCKFORD, ND 58356 US
Tel: 701-947-2944 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1226 1ST AVE N NEW ROCKFORD, ND 58356 US
Tel: 701-947-2944 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | ND | |
N | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | ND | |
N | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility | ND | |
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | ND | 1043A |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
030029 | ND | 05 | |
BLUE CROSS | 1123 | ND | 01 |
WORK FORCE SAFETY | 569350 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin