NPI 1225386774
1303 Group Home
Practice location
- Address
- 1303 7th Ave SE, Mandan, ND 58554-4506
- Phone
- (701) 663-0379
- Mailing address
- 201 4th Ave NW, Mandan, ND 58554-3135
Authorised official
- Name
- Mike Remboldt
- Title
- Ceo
- Phone
- (701) 663-0379
Registered specialties
Intellectual Disabilities Intermediate Care Facility
Primary
Registry record
- NPI
- 1225386774
- Entity type
- Organization
- NPI issued
- 15 Aug 2012
- Record last updated
- 17 Apr 2024
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.