Provider Demographics
NPI:1194501882
Name:REBUILDING TOGETHER OF FARGO-MOORHEAD AREA, INC.
Entity type:Organization
Organization Name:REBUILDING TOGETHER OF FARGO-MOORHEAD AREA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SKALICKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-356-7836
Mailing Address - Street 1:505 BROADWAY N STE 206
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-4489
Mailing Address - Country:US
Mailing Address - Phone:701-356-7836
Mailing Address - Fax:
Practice Address - Street 1:505 BROADWAY N STE 206
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-4489
Practice Address - Country:US
Practice Address - Phone:701-356-7836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No251V00000XAgenciesVoluntary or CharitableGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty