Provider Demographics
NPI:1225217300
Name:HARMONY HOUSE
Entity Type:Organization
Organization Name:HARMONY HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-662-8393
Mailing Address - Street 1:1601 COLLEGE DR N
Mailing Address - Street 2:C/O SPORTS CENTER
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-1550
Mailing Address - Country:US
Mailing Address - Phone:701-662-8393
Mailing Address - Fax:
Practice Address - Street 1:1601 COLLEGE DR N
Practice Address - Street 2:C/O SPORTS CENTER
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-1550
Practice Address - Country:US
Practice Address - Phone:701-662-8393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND50604Medicaid