Provider Demographics
NPI:1295730653
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:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:FARNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-437-3544
Mailing Address - Street 1:110 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:ENDERLIN
Mailing Address - State:ND
Mailing Address - Zip Code:58027-1129
Mailing Address - Country:US
Mailing Address - Phone:701-437-3544
Mailing Address - Fax:701-437-3816
Practice Address - Street 1:110 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:ENDERLIN
Practice Address - State:ND
Practice Address - Zip Code:58027-1129
Practice Address - Country:US
Practice Address - Phone:701-437-3544
Practice Address - Fax:701-437-3816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1074A314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12468OtherND BLUE CROSS
ND30421Medicaid
ND30421Medicaid