| Day, Extended, Ie | |
|
2640 Sunset Dr Mandan ND 58554-1541 | |
| (701) 663-0379 | |
| Not Available |
| Full Name | Day, Extended, Ie |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2640 Sunset Dr, Mandan, North Dakota |
| Authorized Official Name and Position | Paul R Kramer (CFO) |
| Authorized Official Contact | 7016678614 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Day, Extended, Ie 201 4th Ave Nw Mandan ND 58554-3135 Ph: () - | Day, Extended, Ie 2640 Sunset Dr Mandan ND 58554-1541 Ph: (701) 663-0379 |
| NPI Number | 1053912493 |
|---|---|
| Provider Enumeration Date | 11/03/2020 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053912493 | NPI | - | NPPES |
| 1456358 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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