NPI 1164809562
Eventide Fargo LLC
Practice location
- Address
- 3225 51st St S, Fargo, ND 58104-7180
- Phone
- (218) 291-2230
- Mailing address
- 2405 8th St S Suite a, Moorhead, MN 56560-4224
Authorised official
- Name
- Wade E Stubson
- Title
- Cfo
- Phone
- (218) 291-2216
Registered specialties
Skilled Nursing Facility
Primary
Registry record
- NPI
- 1164809562
- Entity type
- Organization
- NPI issued
- 5 May 2015
- Record last updated
- 10 Aug 2016
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.