1303 GROUP HOME (NPI# 1225386774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225386774 |
| Entity Type | Organization |
| Organization Name | 1303 GROUP HOME |
| Practice Address |
1303 7th Ave Se Mandan ND 58554-4506 |
| Mailing Address |
1007 18th St Nw Mandan ND 58554-1639 |
| Practice Telephone | 7016630379 |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2020-10-30 |
| Authorized Official Name | MR. MIKE REMBOLDT (CEO) |
| Authorized Official Telephone | 7016630379 |
| Is Organization Subpart | Y |
| Parent Organization Name | HIT INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 1456205 | 05 | |
| ND | 30879 | 05 |
| Street Address |
1303 7TH AVE SE |
| City | MANDAN |
| State | ND |
| Zip Code | 58554-4506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548782790 | 1150 Group Home | Intermediate Care Facility, Mentally Retarded | 1150 N. Collins Aveue, Mandan, ND 58554 | 2017-07-10 |
| 1871029033 | Anthony Kozojed | Case Manager/Care Coordinator | 701 16th Ave Se, Mandan, ND 58554 | 2017-05-10 |
| 1437690609 | 1140 Grouphome | Intermediate Care Facility, Mentally Retarded | 1140 Collins Ave, Mandan, ND 58554 | 2017-03-20 |
| 1497157895 | West River Head Start | Public Health or Welfare | 1004 7th St Nw, Mandan, ND 58554 | 2014-09-17 |
| 1093134017 | St. Alexius Mandan Pharmacy, LLC | Pharmacy | 2500 Sunset Drive Nw, Suite 2, Mandan, ND 58554 | 2014-04-08 |
| 1639501141 | Lakewood Landing, Inc. | Assisted Living Facility | 4401 21st St Se, Mandan, ND 58554 | 2013-08-07 |
| 1578835641 | Hit Inc. 1301 Grouphome | Intermediate Care Facility, Mentally Retarded | 1301 7th Ave Se, Mandan, ND 58554 | 2012-02-03 |
| 1689953036 | Timothy Lee Ulledahl | Physical Therapy Assistant | 1833 East Bismarck Expressway, Bismarck, ND 58554 | 2011-08-16 |
| 1316232887 | Nagel Family Chiropractic and Wellness LLC | Chiropractor | 2008 Twin City Drive, Mandan, ND 58554 | 2011-06-13 |
| 1598062143 | 1201 Grouphome | Intermediate Care Facility, Mentally Retarded | 1201 7th Ave Se, Mandan, ND 58554 | 2011-02-17 |
| Find all providers in zip 58554 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 1518137009 | Hit Inc. | Intermediate Care Facility, Mentally Retarded | 1901 2nd St Ne, Mandan, ND 58554-3849 | 2008-03-11 |
| 1821268525 | Hit Inc. | Intermediate Care Facility, Mentally Retarded | 1004 27th St Nw, Mandan, ND 58554-1517 | 2008-03-10 |
| 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 |
| 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 |
| 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 |
| 1134395395 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 503 Hilltop Dr, Park River, ND 58270-4203 | 2008-05-07 |
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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.