Provider Demographics
NPI:1467158782
Name:MINOT AREA RECOVERY COMMUNITY ORGANIZATION
Entity Type:Organization
Organization Name:MINOT AREA RECOVERY COMMUNITY ORGANIZATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PERDUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-509-3796
Mailing Address - Street 1:2201 15TH ST SW LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-6935
Mailing Address - Country:US
Mailing Address - Phone:701-509-3796
Mailing Address - Fax:
Practice Address - Street 1:2201 15TH ST SW LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-6935
Practice Address - Country:US
Practice Address - Phone:701-509-3796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management