Provider Demographics
NPI:1689350415
Name:FAMILY HEALTH CARE CENTER
Entity Type:Organization
Organization Name:FAMILY HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF HR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGREGOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-239-2287
Mailing Address - Street 1:301 NP AVE N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-4835
Mailing Address - Country:US
Mailing Address - Phone:701-239-2287
Mailing Address - Fax:
Practice Address - Street 1:100 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:LAMOURE
Practice Address - State:ND
Practice Address - Zip Code:58458-7415
Practice Address - Country:US
Practice Address - Phone:701-271-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY HEALTH CARE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-26
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)