NPIMap

Organization Active NPI

Villa Nazareth

Doing business as Friendship Inc.

  • Community/Behavioral Health Agency
  • Fargo, ND
National Provider Identifier
1578159075
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
VILLA NAZARETH
Doing business as
Friendship Inc.
Practice address
801 Page Dr S
Fargo, ND 58103-2315
Phone
(701) 235-8217
Fax
(701) 235-7538
NPI assigned
Dec 18, 2020
Last updated
Dec 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Authorized official

Name
Dori Leslie
Title
President
Phone
(701) 235-8217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

801 Page Dr S
Fargo, ND 58103-2315

Mailing address

801 Page Dr S
Fargo, ND 58103-2315
Phone (701) 235-8217

Other identifiers 1

IdentifierTypeStateIssuer
1455825MedicaidND

Other names 1

  • Friendship Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Friendship Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1578159075",
    "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": "801 PAGE DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032315",
            "telephone_number": "701-235-8217",
            "fax_number": "701-235-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA NAZARETH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "LESLIE",
        "authorized_official_first_name": "DORI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-235-8217"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455825",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendship Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.