SHAREHOUSE GENESIS NPI 1356576979

NPI Information

NPI: 1356576979
Provider Name: SHAREHOUSE GENESIS
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address: 505 40TH ST S UNIT B
FARGO, ND
ZIP 58103
Phone: (701) 478-8440

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NPI Details

SHAREHOUSE GENESIS is a substance abuse rehabilitation facility in Fargo, ND. The provider is 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. SHAREHOUSE GENESIS NPI is 1356576979. The provider is registered as an organization entity type.

The provider's business location address is:

505 40TH ST S UNIT B
FARGO, ND
ZIP 58103-184
Phone: (701) 478-8440
Fax: (651) 925-0046

The provider's authorized official is Jeremy Traen .
The authorized official title is Ceo/president and has the following contact phone number (701) 532-4345.

The enumeration date for this NPI number is 5/27/2009 and was last updated on 5/1/2025.

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
1	251S00000X	Community/Behavioral Health				No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			No
3	324500000X	Substance Abuse Rehabilitation Facility		1056	NORTH DAKOTA	Yes

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: 3/30/2025

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