VILLA NAZARETH (NPI# 1134395395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134395395 |
| Entity Type | Organization |
| Organization Name | VILLA NAZARETH |
| Other Organization Name | FRIENDSHIP, INC. |
| Practice Address |
503 Hilltop Dr Park River ND 58270-4203 |
| Mailing Address |
801 Page Dr S Fargo ND 58103-2315 |
| Practice Telephone | 7012846453 |
| Practice Fax Number | 7012847548 |
| Mailing Telephone | 7012358217 |
| Mailing Fax Number | 7012357538 |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-05-07 |
| Authorized Official Name | MR. DAVE KEELER (CFO) |
| Authorized Official Telephone | 7012358217 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 30859 | ND | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 30859 | 05 |
| Other Name | Type Code |
|---|---|
| Friendship, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417124462 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 2424 18th St S, Fargo, ND 58103-5110 | 2008-05-09 |
| 1326215369 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 605 Hilltop Dr, Park River, ND 58270-4204 | 2008-05-09 |
| 1326215377 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 1635 34th Ave S, Fargo, ND 58104-6123 | 2008-05-09 |
| 1316113590 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 412 E 10th St, Grafton, ND 58237-1531 | 2008-05-07 |
| 1598931784 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 2502 33rd Ave S, Fargo, ND 58104-8801 | 2008-05-07 |
| 1437213790 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 2302 18th Street South, Fargo, ND 58103-2315 | 2006-12-21 |
| Street Address |
503 HILLTOP DR |
| City | PARK RIVER |
| State | ND |
| Zip Code | 58270-4203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740769595 | The Evangelical Lutheran Good Samaritan Society | Nurse Practitioner | 301 S Highway 12b, Park River, ND 58270 | 2018-08-13 |
| 1104317189 | Paul Benedict Dusek | Dentist | 321 Briggs Ave S Ste 3, Park River, ND 58270 | 2018-05-24 |
| 1669880845 | Lifetime Dental, PC | Clinic/Center | 321 Briggs Ave S, Suite 3, Park River, ND 58270 | 2014-07-31 |
| 1063850436 | Achieve Therapy LLC | Physical Therapist | 102 4th St W, Park River, ND 58270 | 2013-06-07 |
| 1740473800 | Riverview Healthcare Association | Clinic/Center | 115 Vivian St, Park River, ND 58270 | 2007-08-22 |
| 1285847269 | Brian James Larson | Dentist | 418 Briggs Ave S, Park River, ND 58270 | 2007-05-07 |
| 1033137070 | Roberta L Ekman | Dentist | 321 Briggs Ave, Park River, ND 58270 | 2006-07-17 |
| 1679128664 | Lyndsi E Klundt | Physical Therapist | 102 4th St W, Park River, ND 58270 | 2019-08-06 |
| 1508426735 | Allie Beneda | Physical Therapy Assistant | 115 Vivian St., Park River, ND 58270 | 2019-06-19 |
| 1770795767 | Laurelyn Joann Larson | Pharmacist | Highway 17, Park River, ND 58270 | 2007-05-04 |
| Find all providers in zip 58270 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326215369 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 605 Hilltop Dr, Park River, ND 58270-4204 | 2008-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302420 | Lake Region Corporation | Intermediate Care Facility, Mentally Retarded | 2017 Highway 20, Devils Lake, ND 58301-8650 | 2020-06-29 |
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1689197493 | Rem North Dakota | Intermediate Care Facility, Mentally Retarded | 1905 2nd Street Se, Suite 1a, Minot, ND 58701 | 2017-07-24 |
| 1548782790 | 1150 Group Home | Intermediate Care Facility, Mentally Retarded | 1150 N. Collins Aveue, Mandan, ND 58554 | 2017-07-10 |
| 1437690609 | 1140 Grouphome | Intermediate Care Facility, Mentally Retarded | 1140 Collins Ave, Mandan, ND 58554 | 2017-03-20 |
| 1861810053 | Red River Human Services Foundation | Intermediate Care Facility, Mentally Retarded | 903 Mulberry Ln, West Fargo, ND 58078-5000 | 2014-04-03 |
| 1144582933 | Anne Carlsen Center | Intermediate Care Facility, Mentally Retarded | 701 3rd Steeet Nw, Jamestown, ND 58401 | 2012-06-08 |
| 1578835641 | Hit Inc. 1301 Grouphome | Intermediate Care Facility, Mentally Retarded | 1301 7th Ave Se, Mandan, ND 58554 | 2012-02-03 |
| 1598062143 | 1201 Grouphome | Intermediate Care Facility, Mentally Retarded | 1201 7th Ave Se, Mandan, ND 58554 | 2011-02-17 |
| 1407153059 | 1203 Grouphome | Intermediate Care Facility, Mentally Retarded | 1203 7th Ave Se, Mandan, ND 58554 | 2011-02-17 |
| Find all providers with the same taxonomy | ||||
| City | PARK RIVER |
| Zip Code | 58270 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.