Provider Demographics
NPI:1437634706
Name:CARINGEDGE HOSPICE OF FARGO
Entity Type:Organization
Organization Name:CARINGEDGE HOSPICE OF FARGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF HEALTH SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-473-2717
Mailing Address - Street 1:322 DEMERS AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4799
Mailing Address - Country:US
Mailing Address - Phone:701-738-2000
Mailing Address - Fax:
Practice Address - Street 1:4420 37TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-3400
Practice Address - Country:US
Practice Address - Phone:701-365-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based