| NPI | 1871600759 |
|---|---|
| Doing Business As | COUNTRYSIDE INN ASSISTED LIVING & MEMORY CARE |
| Entity Type | Organization |
| Authorized Contact | CHARLES WILLIAM VANDEPUTTE Owner Operator 605-537-4588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: SD 53737) |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) (Licence: SD 53737) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-08-24 |