| NPI | 1124018882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC VANDENHULL CFO 605-362-3100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2021-10-25 |