Organization

Eventide Senior Living Communities Llc

Legal Business Name

Eventide Senior Living Communities Llc

NPI Number

1407984081

NPI Type

Organization

Enumeration Date

03/02/2007

Specialties

(Taxonomies)

Code

311500000X
310400000X

Primary Taxonomy

No
No

Licenses

State

North Dakota
North Dakota

License Number

8100A
63

Contact
Information

Purpose

Mailing
Location

Address

1405 7TH ST S
225 13TH AVENUE WEST

City

Moorhead
West Fargo

State

MN
ND

Postal Code

56560-3444
58078

Country

US
US

Telephone Number

(218) 233-7508
(701) 478-6000

Authorized Official

Name

Mr. Wade Stubson

Title or Position

CFO

Telephone Number

(218) 291-22216

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/22/2020

Provider Address