Provider Demographics
NPI:1518911700
Name:MISSOURI SLOPE LUTHERAN CARE CENTER, INC.
Entity Type:Organization
Organization Name:MISSOURI SLOPE LUTHERAN CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:REIER
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-223-9407
Mailing Address - Street 1:2425 HILLVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3056
Mailing Address - Country:US
Mailing Address - Phone:701-223-9407
Mailing Address - Fax:701-222-6328
Practice Address - Street 1:2425 HILLVIEW AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3056
Practice Address - Country:US
Practice Address - Phone:701-223-9407
Practice Address - Fax:701-222-6328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1004A313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1339OtherBLUE CROSS OF NORTH DAKOT
38520OtherTRICARE
ND030004Medicaid
ND355059Medicare Oscar/Certification