Provider Demographics
NPI:1902615792
Name:DAKOTA RELIANCE HOME CARE
Entity type:Organization
Organization Name:DAKOTA RELIANCE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:DACOLO
Authorized Official - Last Name:KOTEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-934-7055
Mailing Address - Street 1:4704 CENTRAL BAY DR
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-6250
Mailing Address - Country:US
Mailing Address - Phone:701-934-7055
Mailing Address - Fax:
Practice Address - Street 1:4704 CENTRAL BAY DR
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-6250
Practice Address - Country:US
Practice Address - Phone:701-934-7055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health