Full Name | Pride Inc |
---|---|
Speciality | Community/behavioral Health |
Location | 1200 Missouri Ave, Bismarck, North Dakota |
Authorized Official Name and Position | Jamie J Stair Tessness (SENIOR ACCOUNTANT) |
Authorized Official Contact | 7017125125 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pride Inc Po Box 4086 Bismarck ND 58502-4086 Ph: (701) 712-5125 | Pride Inc 1200 Missouri Ave Bismarck ND 58504-5264 Ph: (701) 712-5125 |
NPI Number | 1790385482 |
---|---|
Provider Enumeration Date | 10/30/2020 |
Last Update Date | 10/30/2020 |
Certification Date | 10/27/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790385482 | NPI | - | NPPES |
1456378 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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