| NPI | 1497736615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES T IVERSON Administrator 605-256-4936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: SD 10644) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2020-08-22 |