| NPI | 1265688980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANN KJOS Administrator 605-486-4523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: SD 0083) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: SD 10673) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2009-02-16 |