NPI 1295335495
4th Corporaiton
Practice location
- Address
- 120 11th Street North, New Rockford, ND 58356
- Phone
- (701) 947-2147
Authorised official
- Name
- Kodi Keller
- Title
- Executive Director
- Phone
- (701) 947-2147
Registered specialties
Community/Behavioral Health Agency
Primary
Registry record
- NPI
- 1295335495
- Entity type
- Organization
- NPI issued
- 27 Oct 2020
- Record last updated
- 27 Oct 2020
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.