Villa Nazareth

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

30843 Issued in ND

Legal business name

VILLA NAZARETH

Doing business as

Friendship Inc

Practice address

1635 34TH Ave S
Fargo, ND 58104-6123

Phone

(701) 280-9750

Fax

(701) 232-6021

NPI assigned

May 9, 2008

Last updated

May 9, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dave Keeler

Title

Cfo

Phone

(701) 235-8217

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Friendship Inc Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326215377. Details of each certification follow.

• CCN 35G049 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 35G049

Legal name

Friendship-1635

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jul 14, 1986

Last certification

Oct 28, 2025

Beds

6

Ownership / control type

Private (non-profit)

Facility address

1635 34th Ave S
Fargo, ND 58104

Tax ID family

Friendship Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Villa Nazareth

  dba Friendship, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Park River, ND
  • NPI 1134395395
  NPD tax ID
• Villa Nazareth

  dba Friendship, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Grafton, ND
  • NPI 1316113590
  NPD tax ID
• Villa Nazareth

  dba Friendship Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Park River, ND
  • NPI 1326215369
  NPD tax ID
• Villa Nazareth

  dba Friendship, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Fargo, ND
  • NPI 1417124462
  NPD tax ID
• Villa Nazareth

  dba Friendship, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Fargo, ND
  • NPI 1598931784
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1326215377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 PAGE DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032315",
            "telephone_number": "701-235-8217",
            "fax_number": "701-235-7538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 34TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046123",
            "telephone_number": "701-280-9750",
            "fax_number": "701-232-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA NAZARETH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "KEELER",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "701-235-8217",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "ND",
            "license": "30843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30843",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendship Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luis S Vilella-Gonzalez, M.D.
• Leonid Vilenski, MD
• Andrea Lynn Vilhauer, LCSW
• Diana Vilkama
• Villa Maria (Villa Maria Adult DayCare)
• Villa Nazareth (Friendship Inc.)
• Villa Nazareth (Friendship, Inc.)
• Villa Nazareth (Friendship, Inc.)
• Villa Nazareth (Friendship Inc.)
• Villa Nazareth (Friendship, Inc.)

• Intellectual Disabilities Intermediate Care Facility in Fargo, ND
• Providers in Fargo, ND by specialty
• Intellectual Disabilities Intermediate Care Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.