Provider Demographics
NPI:1538767926
Name:MINOT COMMISSION ON AGING, INC
Entity type:Organization
Organization Name:MINOT COMMISSION ON AGING, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:A
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-852-0561
Mailing Address - Street 1:21 1ST AVENUE SE
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701
Mailing Address - Country:US
Mailing Address - Phone:701-839-2797
Mailing Address - Fax:701-852-0564
Practice Address - Street 1:21 1ST AVENUE SE
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701
Practice Address - Country:US
Practice Address - Phone:701-839-2797
Practice Address - Fax:701-852-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care