TELLEGACY LLC NPI 1215831177

NPI Information

  • NPI: 1215831177
  • Provider Name: TELLEGACY LLC
  • Classification: Clinic/Center - 261QC1500X
  • Specialization: Community Health
  • Entity Type: Organization
  • :
  • Address: 3523 45TH ST S # 164
    FARGO, ND
    ZIP 58104
  • Phone: (419) 270-7511

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NPI Details

TELLEGACY LLC is a community health clinic center in Fargo, ND. TELLEGACY LLC NPI is 1215831177. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

3523 45TH ST S # 164
FARGO, ND
ZIP 58104-962
Phone: (419) 270-7511

The provider's authorized official is Jeremy Christopher Holloway .
The authorized official title is Director and has the following contact phone number (419) 270-7511.

The enumeration date for this NPI number is 10/5/2026 and was last updated on 10/5/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QC1500XClinic/CenterCommunity HealthYes
2261QR1100XClinic/CenterResearchNo
3261QR1300XClinic/CenterRural HealthNo
4251S00000XCommunity/Behavioral HealthNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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