Eastern Star Home of South Dakota Inc.

Key facts

NPI

1063562437

Entity type

Organization (NPI type 2)

Primary specialty

Assisted Living Facility 310400000X

License

9570590 (SD)

Legal business name

EASTERN STAR HOME OF SOUTH DAKOTA INC.

Practice address

126 W 12TH Ave
Redfield, SD 57469-1522

Phone

(605) 472-0658

Fax

(605) 472-3590

NPI assigned

Jan 10, 2007

Organization subpart

No

Authorized official

Name

Mary A Rice

Title

Administrator

Phone

(605) 472-0658

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eastern Star Home of South Dakota Inc Skilled Nursing Facility · Redfield, SD · NPI 1730238973
  NPD tax ID

National Provider Directory

Tax ID family

Eastern Star Home of South Dakota Inc (2 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063562437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "REDFIELD",
            "state": "SD",
            "postal_code": "574691522",
            "telephone_number": "605-472-0658",
            "fax_number": "605-472-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 W 12TH AVE",
            "city": "REDFIELD",
            "state": "SD",
            "postal_code": "574691522",
            "telephone_number": "605-472-0658",
            "fax_number": "605-472-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN STAR HOME OF SOUTH DAKOTA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-472-0658"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "9570590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9570590",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redfield, SD

• Lisa Cosato
• Karlie R Coyle, COTA
• Dakota Dental Clay Yeoman DDS Prof. LLC
• Dewi Frances Tonelete Depositario-Cabacar, MD
• Eastern Star Home of South Dakota Inc
• Cathy Frericks, PT
• Olivia Full, DPT
• Rylie Gall
• Melissa Gorecki
• Scott J Hartung, DC

All providers in Redfield, SD · Assisted Living Facility in South Dakota