# WONDERFUL-HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518738582
- **Authorized official:** ANGIE K LEWIS (CO-OWNER)
- **Authorized official phone:** (267) 304-8811

## Contact information

- **Practice address:** 7708 W ELI CT, SIOUX FALLS, SD 57106-7203
- **Practice address phone:** (267) 304-8811
- **Mailing address:** 7708 W ELI CT, SIOUX FALLS, SD 57106-7203
- **Mailing address phone:** (267) 304-8811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/09/2024
- **Last updated:** 01/09/2024