Pine Lane Estates LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

46906 Issued in SD

Legal business name

PINE LANE ESTATES LLC

Practice address

2905 Douglas Ave
Yankton, SD 57078

Phone

(605) 665-7255

Fax

(605) 668-2730

NPI assigned

Jan 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Deanna Jo Loecker

Title

Administrator

Phone

(605) 665-7255

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104976356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 DOUGLAS AVE",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "57078",
            "telephone_number": "605-665-7255",
            "fax_number": "605-668-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 DOUGLAS AVE",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "57078",
            "telephone_number": "605-665-7255",
            "fax_number": "605-668-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE LANE ESTATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOECKER",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-665-7255",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "46906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9571690",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael E Peterson, M.D.
• Savannah M Pewett
• William Douglas Pierce, PHD
• Michael P Pietila, M.D.
• Carrissa M Pietz, MD
• Molly Pingrey
• Mary Joan Polak
• Kevin C Pons, MA CCC
• Nicholas Poppe, CRNA
• Christine Mary Pospishil, RN

• Assisted Living Facility in Yankton, SD
• Providers in Yankton, SD by specialty
• Assisted Living Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.