Provider Demographics
NPI:1205517398
Name:SNOH QUALITY CARE SERVICES
Entity type:Organization
Organization Name:SNOH QUALITY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QSP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAI
Authorized Official - Middle Name:MARDEA
Authorized Official - Last Name:MERCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-730-3036
Mailing Address - Street 1:1574 68TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-3005
Mailing Address - Country:US
Mailing Address - Phone:701-730-3036
Mailing Address - Fax:
Practice Address - Street 1:1574 68TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-3005
Practice Address - Country:US
Practice Address - Phone:701-730-3036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1396458360Medicaid