Provider Demographics
NPI:1841691789
Name:TUFTE MANOR
Entity type:Organization
Organization Name:TUFTE MANOR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE PROJECT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-787-7970
Mailing Address - Street 1:3300 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-7699
Mailing Address - Country:US
Mailing Address - Phone:701-787-7600
Mailing Address - Fax:
Practice Address - Street 1:3300 CHERRY ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-7634
Practice Address - Country:US
Practice Address - Phone:701-787-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY HOMES & SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-10
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND000030778Medicaid