1140 GROUPHOME is an intermediate care facility mentally retarded in Mandan, ND. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. 1140 GROUPHOME NPI is 1437690609. The provider is registered as an organization entity type.
The provider's business location address is:
1140 COLLINS AVE
MANDAN, ND
ZIP 58554
Phone: (701) 663-0379
The provider's authorized official is Mike Remboldt .
The authorized official title is Ceo and has the following contact phone number (701) 667-8612.
The enumeration date for this NPI number is 3/20/2017 and was last updated on 4/17/2024.