IndividualActive
Fashingoma Mugisha
NPI 1649164963 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Fargo, ND
Provider details
- NPI number
- 1649164963
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
905 27th St N
Fargo, ND 58102-3134
Phone: (602) 751-1571
Approximate (ZIP-level) locationGet directions
Mailing address
22453 N Vanderveen Way
Maricopa, AZ 85138-5570
Registry dates
- Enumerated
- 2025-06-03
- Last updated
- 2025-06-03
- Certified
- 2025-06-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.