DICKINSON COUNTRYHOUSE LLC NPI 1548050461

NPI Information

NPI: 1548050461
Provider Name: DICKINSON COUNTRYHOUSE LLC
Classification: Alzheimer Center (Dementia Center) - 311500000X
Entity Type: Organization
:
Address: 628 24TH ST W
DICKINSON, ND
ZIP 58601
Phone: (701) 847-0842

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NPI Details

DICKINSON COUNTRYHOUSE LLC is an alzheimer center dementia center in Dickinson, ND. The provider is a freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. DICKINSON COUNTRYHOUSE LLC NPI is 1548050461. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

628 24TH ST W
DICKINSON, ND
ZIP 58601-731
Phone: (701) 847-0842

The provider's authorized official is Stacy Randels .
The authorized official title is Vp Asset Management and has the following contact phone number (531) 800-3364.

The enumeration date for this NPI number is 5/12/2025 and was last updated on 5/23/2025.

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	253Z00000X	In Home Supportive Care				No
2	311500000X	Alzheimer Center (Dementia Center)				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: 11/21/2025

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