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Contact Information

LIGHTHOUSE CHURCH OF FARGO
111 9TH ST S
FARGO, ND58103-1831
 Phone: 701-212-8626
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Manager/Care Coordinator

171M00000X
 

Community/Behavioral Health

251S00000X
 

Private Vehicle

347C00000X
Indicates primary specialty

NPI Profile & details for LIGHTHOUSE CHURCH OF FARGO · (Female)

NPI Number 1316531817
Status Active
Credentials
Entity Individual
Enumeration date 02/24/2021
Last updated 02/24/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers
  • ND Medicaid 251B00000X
  • ND Medicaid 251S00000X
  • ND Medicaid 347C00000X
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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