Menno-Olivet Retirement Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10648 Issued in SD

Legal business name

MENNO-OLIVET RETIREMENT HOME INC

Doing business as

Menno-Olivet Care Center

Practice address

402 South Pine Street
Menno, SD 57045-0487

Phone

(605) 387-5139

Fax

(605) 387-2441

NPI assigned

Nov 7, 2005

Last updated

Jun 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judith Ann Headley

Title

Administrator

Phone

(605) 387-5139

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MENNO-OLIVET CARE CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629059761. Details of each certification follow.

• CCN 435113 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 435113

Legal name

MENNO-OLIVET RETIREMENT HOME INC

Doing business as

MENNO OLIVET CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 1998

Last certification

Oct 30, 2024

Beds

41

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 15, 1968 in SD

Enrollment address

402 S Pine St
Menno, SD 57045-0487

Nursing home name

MENNO-OLIVET CARE CENTER

Listed as

Menno-Olivet Care CenterCCN 435113 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Apr 1, 1998

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4122.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Menno-Olivet Assisted Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Menno-Olivet Retirement Home Inc

  dba Menno-Olivet Assisted Living

  • Assisted Living Facility
  • Menno, SD
  • NPI 1225349814
  NPD tax ID

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Troy T Swier, LCSW

  • Clinical Social Worker
  • Menno, SD
  • NPI 1346530771
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Shakil I Hafiz, D.O.

  • Family Medicine Physician
  • Freeman, SD
  • NPI 1831454263

  Nursing home

  Care Compare affiliation
• Larissa Sanger, M.D.

  • Family Medicine Physician
  • Billings, MT
  • NPI 1518287457

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1629059761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "MENNO",
            "state": "SD",
            "postal_code": "570450487",
            "telephone_number": "605-387-5139",
            "fax_number": "605-387-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 SOUTH PINE STREET",
            "city": "MENNO",
            "state": "SD",
            "postal_code": "570450487",
            "telephone_number": "605-387-5139",
            "fax_number": "605-387-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENNO-OLIVET RETIREMENT HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "HEADLEY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-387-5139"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SD",
            "license": "10648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160260",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MENNO-OLIVET CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• City of Menno (Menno Ambulance Service)
• Freeman Regional Health Services
• Catherine Diane Friesen, A.R.N.P.
• Menno School District 33-2
• Menno-Olivet Retirement Home Inc (Menno-Olivet Assisted Living)
• Andrea M. Miller, M.A., CCC-SLP
• Rural Medical Clinics, PA (Menno Clinic)
• Ann Margaret Schultz, RDLN
• Briana Stahl, OTR/L
• Troy T Swier, LCSW

• Skilled Nursing Facility in Menno, SD
• Providers in Menno, SD by specialty
• Skilled Nursing Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.