Provider Demographics
NPI:1598760803
Name:SISTERS OF MARY OF THE PRESENTATION LONG-TERM CARE
Entity Type:Organization
Organization Name:SISTERS OF MARY OF THE PRESENTATION LONG-TERM CARE
Other - Org Name:SHEYENNE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CHRISTIANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-845-8222
Mailing Address - Street 1:979 CENTRAL AVE N
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58072-2149
Mailing Address - Country:US
Mailing Address - Phone:701-845-8222
Mailing Address - Fax:701-845-8270
Practice Address - Street 1:979 CENTRAL AVE N
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:ND
Practice Address - Zip Code:58072-2149
Practice Address - Country:US
Practice Address - Phone:701-845-8222
Practice Address - Fax:701-845-8270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1053B313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND30418Medicaid
ND355077Medicare Oscar/Certification
ND30418Medicaid