Trustees of Nonprofit / Chain Home Office (check one) Joint Venture / For / Individual County Corporation / Directors / /
Event
Business Partnership / /
Facility
facility Telephone Number FAX Number E-Mail Address Provider Number / /
IndustryTerm
work telephone number / /
Organization
Social Security Administration / North Dakota Medical Assistance Program / Home Office / Any hospital / ND Medicaid / State Medicaid Agency / OWNERSHIP/CONTROLLING INTEREST AND CONVICTION INFORMATION DEPARTMENT OF HUMAN SERVICES MEDICAL SERVICES DIVISION Clear Fields SFN / Department of Health and Human Services / Internal Revenue Service / Medicare / /
Position
Contractor / Representative / administrator / director / director of a disclosing entity / general manager / business manager / administrator / Nursing Director / Secretary / officer / Administrator / /
OWNERSHIP/CONTROLLING INTEREST AND CONVICTION INFORMATION DEPARTMENT OF HUMAN SERVICES MEDICAL SERVICES DIVISION Clear Fields