4TH Corporaiton
Organization Active NPI Community/Behavioral Health Agency · New Rockford, ND
NPI 1295335495 · NPPES record last updated Oct 27, 2020
Key facts
- NPI
- 1295335495
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- 4TH CORPORAITON
- Practice address
- 120 11TH Street North
New Rockford, ND 58356 - Phone
- (701) 947-2147
- NPI assigned
- Oct 27, 2020
- Organization subpart
- No
Authorized official
- Name
- Kodi Keller
- Title
- Executive Director
- Phone
- (701) 947-2147
Corporate family (same tax ID) 4
National Provider Directory
- Tax ID family
- 4TH Corporaiton
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
120 11TH Street North
New Rockford, ND 58356
Mailing address
120 11TH Street North
New Rockford, ND 58356
Phone (701) 947-2147
Other providers in New Rockford, ND
All providers in New Rockford, ND · Community/Behavioral Health Agency in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.