GOODCLOVER, LLC (NPI# 1184247975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184247975 |
| Entity Type | Organization |
| Organization Name | GOODCLOVER, LLC |
| Practice Address |
405 Main Ave W Unit 4j West Fargo ND 58078-1665 |
| Practice Telephone | 7012480818 |
| Mailing Telephone | 7012480818 |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-05-27 |
| Authorized Official Name | JENNIFER LANDPHERE (OWNER) |
| Authorized Official Telephone | 7072480818 |
| Authorized Official Credential | LCAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
405 MAIN AVE W UNIT 4J |
| City | WEST FARGO |
| State | ND |
| Zip Code | 58078-1665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205068 | Ashley Kasson Therapy | Counselor | 3220 4th St E, West Fargo, ND 58078 | 2020-11-04 |
| 1427658624 | Deedee (dorin) Ngwe | Technician | 3240 9th S West Apt. 204, West Fargo, ND 58078 | 2020-10-27 |
| 1053879734 | Mpnd,inc | Pharmacy | 2050 Sheyenne Street, West Fargo, ND 58078 | 2019-03-12 |
| 1396239216 | Luke Gable | Behavior Technician | 647 13th Avenue South, West Fargo, ND 58078 | 2018-06-15 |
| 1629597919 | Cody Freng | Specialist/Technologist | 3276 9th St W Apt C, West Fargo, ND 58078 | 2017-09-18 |
| 1831613942 | Lauren Phyllis Loe | Physical Therapist | 1401 13th Avenue East, Essentia Health West Fargo Clinic, West Fargo, ND 58078 | 2017-07-31 |
| 1851746226 | Jodi Kilen | Occupational Therapy Assistant | 631 4th Ave East, West Fargo, ND 58078 | 2016-05-04 |
| 1922490101 | Betty Ann Helmer | Social Worker | 2355 Meadow Ridge Parkway, West Fargo, ND 58078 | 2015-02-25 |
| 1477972784 | Tessa Nicole Larson | Occupational Therapist | 3139 Bluestem Dr Ste 108, West Fargo, ND 58078 | 2014-04-15 |
| 1023432010 | Kaylyn Kortes | Licensed Practical Nurse | 1302 Sheyenne St, West Fargo, ND 58078 | 2014-02-11 |
| Find all providers in zip 58078 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730703984 | Turtle Mountain Band of Chippewa Indians | Substance Abuse Rehabilitation Facility | 1105 Sheldon Souray Avenue, Belcourt, ND 58316-0520 | 2020-06-03 |
| 1306308101 | Summit Silver Creek, LLC | Substance Abuse Rehabilitation Facility | 2046 125th Ave, Watford City, ND 58854 | 2019-04-02 |
| 1447736780 | Advance In Recovery, Pllc | Substance Abuse Rehabilitation Facility | 1206 Main St, Carrington, ND 58421-1902 | 2018-07-18 |
| 1003367103 | Medicine Horse Counseling, Pllc | Substance Abuse Rehabilitation Facility | 10435 63rd Ave Ne, Rocklake, ND 58365-9517 | 2016-10-24 |
| 1598079394 | Jessica Ann Brown | Substance Abuse Rehabilitation Facility | 1202 23rd St S, Fargo, ND 58103-2951 | 2010-08-04 |
| 1255656765 | Transitional Living Center Inc | Substance Abuse Rehabilitation Facility | 4399 88th Ave Ne, Devils Lake, ND 58301-8704 | 2010-03-29 |
| 1235452921 | New Beginnings Recovery Center | Substance Abuse Rehabilitation Facility | 693 5th Ave Sw, Dickinson, ND 58601-5808 | 2010-03-09 |
| 1265660187 | West Central Human Service Center | Substance Abuse Rehabilitation Facility | 412 Birchwood Dr, Bismarck, ND 58504-6209 | 2009-06-30 |
| 1356576979 | Sharehouse Genesis | Substance Abuse Rehabilitation Facility | 505 40th St S Unit B, Fargo, ND 58103-1184 | 2009-05-27 |
| 1366681918 | Prairie St. John's, LLC | Substance Abuse Rehabilitation Facility | 510 4th St. South, Fargo, ND 58103 | 2009-02-05 |
| Find all providers with the same taxonomy | ||||
| City | WEST FARGO |
| Zip Code | 58078 |
Please comment or provide details below to improve the information on GOODCLOVER, LLC.
| 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.