Provider Demographics
NPI:1043912967
Name:SISTERS OF MARY OF THE PRESENTATION LONG TERM CARE
Entity type:Organization
Organization Name:SISTERS OF MARY OF THE PRESENTATION LONG TERM CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:AUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-845-8202
Mailing Address - Street 1:979 CENTRAL AVE N
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58072-2149
Mailing Address - Country:US
Mailing Address - Phone:701-845-8222
Mailing Address - Fax:
Practice Address - Street 1:979 CENTRAL AVE N
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:ND
Practice Address - Zip Code:58072-2149
Practice Address - Country:US
Practice Address - Phone:701-845-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1455473Medicaid