National Provider Identifier Database

SHAREHOUSE GENESIS
Substance Abuse Disorder Rehabilitation Facility

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.


Contact Information

SHAREHOUSE GENESIS
505 40TH ST S UNIT B
FARGO, ND58103-1184
Phone: 701-478-8440
Fax: 651-925-0046
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X
Community/Behavioral Health 251S00000X
Rehabilitation, Substance Use Disorder 261QR0405X

* Indicates primary specialty

NPI Profile & details for SHAREHOUSE GENESIS

NPI Number 1356576979
Legal business name
LBN
SHAREHOUSE GENESIS
Authorized official JEREMY TRAEN - (CEO/PRESIDENT)
Entity Organization
Organization subpart Yes
Enumeration date 05/27/2009
Last updated 02/17/2026 - About 4 months ago
Sole proprietor1 Not specified
Identifiers
  • ND License #: 1056

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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