Park Place SD Assisted Living Facility LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PARK PLACE SD ASSISTED LIVING FACILITY LLC

Practice address

1105 S 2ND St
Milbank, SD 57252-3321

Phone

(605) 432-4556

Fax

(605) 432-5725

NPI assigned

May 9, 2019

Organization subpart

No

Name

Menachem Shabat

Title

Coo/Principal

Phone

(847) 679-9797

• Wellshire Park Place Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 9, 2019.

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1639735160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951",
            "telephone_number": "847-679-9797",
            "fax_number": "847-679-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 S 2ND ST",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572523321",
            "telephone_number": "605-432-4556",
            "fax_number": "605-432-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE SD ASSISTED LIVING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "SHABAT",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_title_or_position": "COO/PRINCIPAL",
        "authorized_official_telephone_number": "847-679-9797"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellshire Park Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Milbank, SD
• Assisted Living Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.