Golden Ridge Ventures LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

41975 Issued in SD

Legal business name

GOLDEN RIDGE VENTURES LLC

Practice address

200 Montana Ave
Lead, SD 57754-1051

Phone

(605) 722-6380

Fax

(918) 960-9856

NPI assigned

Sep 8, 2017

Last updated

Sep 8, 2017By 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

Doug Dernier

Title

Owner

Phone

(660) 281-3180

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504828800000",
    "number": "1861910960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577090745",
            "telephone_number": "660-281-3180",
            "fax_number": "918-960-9856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MONTANA AVE",
            "city": "LEAD",
            "state": "SD",
            "postal_code": "577541051",
            "telephone_number": "605-722-6380",
            "fax_number": "918-960-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN RIDGE VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-08",
        "last_updated": "2017-09-08",
        "status": "A",
        "authorized_official_last_name": "DERNIER",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-281-3180"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "41975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staci Carsten, LMT
• Jamie Kay Dahl, LPC
• Steven Warren Fox, D.M.D.
• Golden Ridge Assited Living
• Kristy Nicole Greene, CCC, MS
• Todd Kevin Jones, DDS
• Garrett Kohler, LPC
• Kort Herman DMD PC
• P. Rene Larson

• Assisted Living Facility in Lead, SD
• Providers in Lead, 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 Sep 8, 2017; 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.