United Retirement Center
Organization Active NPI Skilled Nursing Facility · Brookings, SD
NPI 1851373138 · NPPES record last updated Sep 11, 2019
Key facts
- NPI
- 1851373138
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 10601 (SD)
- Legal business name
- UNITED RETIREMENT CENTER
- Practice address
- 405 1St Ave
United Living Community
Brookings, SD 57006-1835 - Phone
- (605) 692-5351
- Fax
- (605) 692-3556
- NPI assigned
- Nov 14, 2005
- Organization subpart
- No
Authorized official
- Name
- Joshua Johnson
- Title
- Director of Finance
- Phone
- (567) 344-0346
Facilities with the same owner 8
Practitioners 1
Affiliated clinicians 7
-
Daniel Cecil, MD
Medicare Care Compare: Nursing home
- Listed as
- United Living Community
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jul 1, 1994
- Medicare certification status
- Active
- Certified beds
- 67 · 65.1 residents per day on average
- Penalties (3 years)
- 2 · fines totaling $33,027
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 43D0687950 | United Living Community | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
Skilled nursing facility certification: CCN 435079
- Legal name
- UNITED RETIREMENT CENTER
- Doing business as
- UNITED LIVING COMMUNITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1994
- Last certification
- May 23, 2024
- Beds
- 81 (67 certified)
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 16, 1956 in SD
- Enrollment address
- 405 1St Ave
Brookings, SD 57006-1835 - Nursing home name
- UNITED LIVING COMMUNITY
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Joan Baker |
Corporate Director |
Apr 28, 2019 | |
| Avera McKennan |
Operational/Managerial Control | Nov 15, 2005 | |
| Julie Bell |
Corporate Director |
Apr 28, 2019 | |
| Alice Harrison |
Corporate Director |
Sep 28, 2019 | |
| Helen Nielsen |
Corporate Director |
Apr 28, 2019 | |
| United Retirement Center |
5% Or Greater Direct Ownership Interest | Jan 1, 1966 | 100% |
| Rebecca Schmieding |
Corporate Director |
Apr 28, 2019 | |
| Camille Koolmo |
Corporate Officer |
Jul 11, 2011 | 5% |
| James Gilkerson |
Corporate Director |
May 1, 2014 | |
| Kaleb Hight |
Contracted Managing Employee |
Oct 2, 2017 | |
| Joshua Johnson |
Corporate Officer |
Mar 1, 2019 | 5% |
| Robert Brotsky |
Corporate Director |
May 1, 2014 | |
| Mary Jo Lee |
Corporate Director |
Apr 28, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080909000125 | SD | Part a Provider - Skilled Nursing Facility | 4385710748 | Practice locations: Brookings, SD |
National Provider Directory
Locations
405 1st Ave
Brookings, SD 57006
Phone (605) 692-5351
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 10601 | SD | Yes |
| Skilled Nursing Facility | 314000000X | 0160050 | SD |
Addresses
Primary practice location
405 1St Ave
United Living Community
Brookings, SD 57006-1835
Mailing address
405 1St Ave
United Living Community
Brookings, SD 57006-1835
Phone (605) 692-5351
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0160050 | Medicaid | SD |
Other names
- United Living Community
Other providers in Brookings, SD
- Tumbleweed Counseling LLC
- Gerald L. Turner
- Clayton Paul Twitero
- Kandi Tyner
- Andrea Uckert
- Hillary Van Dyke
- Gary Cornelius Van Riper
- Rebecca Vande Kop
- Linda K Vande Weerd
- Katy J Vanderwal
All providers in Brookings, SD · Skilled Nursing Facility in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.