VILLA NAZARETH (NPI# 1598931784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598931784 |
| Entity Type | Organization |
| Organization Name | VILLA NAZARETH |
| Other Organization Name | FRIENDSHIP, INC. |
| Practice Address |
2502 33rd Ave S Fargo ND 58104-8801 |
| Mailing Address |
801 Page Dr S Fargo ND 58103-2315 |
| Practice Telephone | 7012323352 |
| Practice Fax Number | 7012326189 |
| Mailing Telephone | 7012358217 |
| Mailing Fax Number | 7012357583 |
| 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 | 30844 | ND | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 30844 | 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 |
| 1134395395 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 503 Hilltop Dr, Park River, ND 58270-4203 | 2008-05-07 |
| 1437213790 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 2302 18th Street South, Fargo, ND 58103-2315 | 2006-12-21 |
| Street Address |
2502 33RD AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58104-8801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| 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 |
|---|---|---|---|---|
| 1417124462 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 2424 18th St S, Fargo, ND 58103-5110 | 2008-05-09 |
| 1326215377 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 1635 34th Ave S, Fargo, ND 58104-6123 | 2008-05-09 |
| 1932313889 | Fraser, Ltd | Intermediate Care Facility, Mentally Retarded | 2902 University Dr S, Fargo, ND 58103-6032 | 2007-05-10 |
| 1437213790 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 2302 18th Street South, Fargo, ND 58103-2315 | 2006-12-21 |
| 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 | ||||
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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.