Provider Demographics
NPI:1356058184
Name:SERVING FAMILY LLC
Entity type:Organization
Organization Name:SERVING FAMILY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LADUCER-SPEERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-210-1259
Mailing Address - Street 1:1810 7TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-3014
Mailing Address - Country:US
Mailing Address - Phone:170-121-0125
Mailing Address - Fax:
Practice Address - Street 1:1810 7TH AVE N
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-3014
Practice Address - Country:US
Practice Address - Phone:170-121-0125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health