Provider Demographics
NPI:1669072294
Name:WP-ARC MINOT HOLDINGS, LLC
Entity type:Organization
Organization Name:WP-ARC MINOT HOLDINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT ANALYST
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-595-6025
Mailing Address - Street 1:601 24TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-7099
Mailing Address - Country:US
Mailing Address - Phone:701-858-9800
Mailing Address - Fax:701-858-9801
Practice Address - Street 1:601 24TH AVE SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-7099
Practice Address - Country:US
Practice Address - Phone:701-858-9800
Practice Address - Fax:701-858-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility