Provider Demographics
NPI:1013303361
Name:RONALD MCDONALD HOUSE CHARITIES
Entity Type:Organization
Organization Name:RONALD MCDONALD HOUSE CHARITIES
Other - Org Name:RMHC SCHOOL BASED SEALANT PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-258-8551
Mailing Address - Street 1:PO BOX 7323
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58507-7323
Mailing Address - Country:US
Mailing Address - Phone:701-258-8551
Mailing Address - Fax:
Practice Address - Street 1:609 N 7TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3927
Practice Address - Country:US
Practice Address - Phone:701-258-8551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty