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Organization
WISDOM IN AGE LLC
Active
Organization
WISDOM IN AGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICKI L KENNEDY (MANAGER)
(605) 721-9473
Entity
Organization
Contact information
Practice address
3704 W MAIN ST, RAPID CITY, SD 57702-2139
(605) 721-9473
Mailing address
3704 W MAIN ST, RAPID CITY, SD 57702-2139
(605) 721-9473
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
47608
SD
Other
Enumeration date
11/23/2008
Last updated
11/23/2008
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