Eastern Star Home Of South Dakota Inc.

NPI 1063562437 - Assisted Living Facility - 310400000X

NPI Details
NPI 1063562437
Enumeration Date 01/10/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARY A MARY
Position ADMINISTRATOR
Phone (605) 472-0658
Fax (605) 472-3590
Practice Location
126 W 12TH AVE
REDFIELD SD, 57469-1522, US
Phone (605) 472-0658
Fax (605) 472-3590
Business Location
PO BOX 150
REDFIELD SD, 57469-1522, US
Phone (605) 472-0658
Fax (605) 472-3590
Toxanomy
Taxonomy Code 310400000X
License State South Dakota
License Number 9570590
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According to our database, Eastern Star Home Of South Dakota Inc. NPI is 1063562437, taxonomy code is 310400000X and license number is 9570590, license state is located at South Dakota. Eastern Star Home Of South Dakota Inc. physically located at 126 W 12th Ave, Redfield SD, 57469-1522. NPI Number 1033115704 has the healthcare provider type.

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1063562437 NPI number is provided on an as is basis without warranty of any kind. 1063562437 is maintained by the National Plan & Provider Enumeration System. The contents of Eastern Star Home Of South Dakota Inc. are for informational purposes only.