Provider Demographics
NPI:1205903481
Name:SHAREHOUSE, INC.
Entity type:Organization
Organization Name:SHAREHOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MACC
Authorized Official - Phone:701-478-9517
Mailing Address - Street 1:4227 9TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-2018
Mailing Address - Country:US
Mailing Address - Phone:701-282-6561
Mailing Address - Fax:701-277-0306
Practice Address - Street 1:4227 9TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2018
Practice Address - Country:US
Practice Address - Phone:701-282-6561
Practice Address - Fax:701-277-0306
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHAREHOUSE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-30
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1056324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility