Rosholt Country Inn

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

53737 Issued in SD

Legal business name

ROSHOLT COUNTRY INN

Doing business as

Countryside Inn Assisted Living & Memory Care

Practice address

208 Prairie Ave
Rosholt, SD 57260-0218

Phone

(605) 537-4588

Fax

(605) 537-4890

NPI assigned

Aug 24, 2006

Last updated

Aug 24, 2007By 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

Mr. Charles William Vandeputte

Title

Owner - Operator

Phone

(605) 537-4588

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Countryside Inn Assisted Living & Memory Care Doing business as

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1871600759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 PRAIRIE AVE",
            "address_2": "PO BOX 218",
            "city": "ROSHOLT",
            "state": "SD",
            "postal_code": "572600218",
            "telephone_number": "605-537-4588",
            "fax_number": "605-537-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 PRAIRIE AVE",
            "city": "ROSHOLT",
            "state": "SD",
            "postal_code": "572600218",
            "telephone_number": "605-537-4588",
            "fax_number": "605-537-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSHOLT COUNTRY INN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "VANDEPUTTE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER - OPERATOR",
        "authorized_official_telephone_number": "605-537-4588",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "53737",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "SD",
            "license": "53737",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9570820",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Countryside Inn Assisted Living & Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Border Rehab, Inc
• Coteau Des Prairies Hospital (Coteau des Prairies Health Care System - Rosholt Clinic)
• Joseph Kass
• Northeast Ambulance Service
• Northeast Care and Rehabilitation Center Inc
• Rosholt Nursing Inc. (Rosholt Care Center)
• Rosholt School District 54 4
• Magdalena Wieser

• Assisted Living Facility in Rosholt, SD
• Providers in Rosholt, 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 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.

Verify at the official NPI Registry.