Meadow Lake Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

10727 Issued in SD

Legal business name

MEADOW LAKE ASSISTED LIVING

Practice address

17444 Meadow Lake Rd
Watertown, SD 57201-9181

Phone

(605) 882-4388

Fax

(605) 882-4388

NPI assigned

Mar 10, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Emil Wiese

Title

Owner

Phone

(605) 882-4388

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joyce Wendel

  • Assisted Living Facility
  • Watertown, SD
  • NPI 1831399336
  NPD (past)

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1992975627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17444 MEADOW LAKE RD",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572019181",
            "telephone_number": "605-882-4388",
            "fax_number": "605-882-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17444 MEADOW LAKE RD",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572019181",
            "telephone_number": "605-882-4388",
            "fax_number": "605-882-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOW LAKE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "WIESE",
        "authorized_official_first_name": "EMIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-882-4388",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "10727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9570730",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carla J McGregor, OPTICIAN
• Megan Johannah McKnight
• Elizabeth McMahon, PHARMD
• Bethany McMullen, DC
• William Devon McMullen, DC
• Melissa Marie Meester, LCSW-PIP
• Bradley G Meier, OD
• Meltdown Day Spa
• David Evan Mendel, LCSW
• Megan Merkel, CNP

• Assisted Living Facility in Watertown, SD
• Providers in Watertown, 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 Mar 10, 2008; 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.