Active NPI
Paradise Pines LLC
- Assisted Living Facility
- Rapid City, SD
National Provider Identifier
1811180565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 47202
- Legal business name
- PARADISE PINES LLC
- Doing business as
- Morningstar ALC
- Practice address
- 4110 Winfield Street
Rapid City, SD 57701 - Phone
- (605) 348-2596
- Fax
- (605) 342-4119
- NPI assigned
- Aug 24, 2007
- Organization subpart
- Yes
- Parent organization
- PARADISE PINES LLC DBA MORNINGSTAR ALC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Janice Kay Zandstra, BSN RN
- Title
- Member for Paradise Pines LLC
- Phone
- (605) 342-2385
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 47202 | SD | Primary |
| Assisted Living Facility | 310400000X | 51260 | SD |
Addresses
Primary practice location
4110 Winfield Street
Rapid City, SD 57701
Mailing address
429 Alta Vista Drive
Rapid City, SD 57701
Phone (605) 342-2385
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9571202 | Medicaid | SD |
Other names 1
- Morningstar ALC
National Provider Directory
National Provider Directory- Part of
- Paradise Pines LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187913600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187913600000",
"number": "1811180565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "429 ALTA VISTA DRIVE",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "57701",
"telephone_number": "605-342-2385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4110 WINFIELD STREET",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "57701",
"telephone_number": "605-348-2596",
"fax_number": "605-342-4119"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARADISE PINES LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PARADISE PINES LLC DBA MORNINGSTAR ALC",
"enumeration_date": "2007-08-24",
"last_updated": "2007-08-24",
"status": "A",
"authorized_official_last_name": "ZANDSTRA",
"authorized_official_first_name": "JANICE",
"authorized_official_middle_name": "KAY",
"authorized_official_title_or_position": "MEMBER FOR PARADISE PINES LLC",
"authorized_official_telephone_number": "605-342-2385",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "BSN RN"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "SD",
"license": "47202",
"primary": true
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "SD",
"license": "51260",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9571202",
"state": "SD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Morningstar ALC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Rapid City, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.