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4TH CORPORAITON
NPI 1114527322
Community/Behavioral Health in New Rockford, ND

Active since October 27, 2020CLIA 35D2107702 · Waiver
1006 2ND AVENUE NORTH, NEW ROCKFORD, ND 58356(701) 947-2147 Get Directions Write a Review

NPPES record last updated: October 27, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About 4th Corporaiton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

4TH CORPORAITON (NPI 1114527322) is a healthcare organization registered as a community/behavioral health in New Rockford, North Dakota and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through January 19, 2028 and lists Kodi Keller, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1114527322
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business Name4TH CORPORAITON
Location Address1006 2ND AVENUE NORTHNew Rockford, ND 58356
Mailing Address120 11th Street NorthNew Rockford, ND 58356 · (701) 947-2147
Phone(701) 947-2147
Organization SubpartNo
Authorized OfficialKodi KellerExecutive Director · (701) 947-2147
Enumeration DateOctober 27, 2020
NPPES CertifiedOctober 27, 2020
✔ NPI 1114527322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
1006 2ND AVENUE NORTH, New Rockford, ND 58356
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 35D2107702

4th Corporation · New Rockford, ND
Active · expires Jan 19, 2028
CLIA Number35D2107702
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateJanuary 20, 2026
Certificate Expiration DateJanuary 19, 2028
Laboratory DirectorKodi Keller
Laboratory Phone(701) 947-2147
Laboratory Location4th Corporation120 11th St, New Rockford, ND 58356
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 4th Corporaiton's NPI number?

The NPI number for 4th Corporaiton is 1114527322. It was assigned to this organization in the NPPES registry on October 27, 2020.

Where is 4th Corporaiton located?

4th Corporaiton is located at 1006 2nd Avenue North, New Rockford, ND 58356. The listed phone number is (701) 947-2147.

What is 4th Corporaiton's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Does 4th Corporaiton hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 35D2107702) is associated with this NPI, valid through January 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for 4th Corporaiton was last updated on October 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.