| Organization Name: | CHI HEALTH CONNECT AT HOME - FARGO |
| NPI Number: | 1396050860 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEANNA KAINZ (CONTROLLER) |
| Mailing Address: | 367 2nd Street Nw Valley City |
| State: | ND US |
| Postal Code: | 580722971 |
| Phone Number: | 7012378133 |
| Fax Number: | 7012378188 |
| NPI Enumeration Date: | 08/09/2010 |
| NPI Last Update Date: | 05/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 6015A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |