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Organization
THE VICTORIAN ASSISTED LIVING HOME
Active
Organization
THE VICTORIAN ASSISTED LIVING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAVON JEAN HUNEKE RN (MANAGER)
(605) 342-1913
Entity
Organization
Contact information
Practice address
1321 COLUMBUS ST, RAPID CITY, SD 57701-2524
(605) 342-1913
(605) 348-2870
Mailing address
1321 COLUMBUS ST, RAPID CITY, SD 57701-2524
(605) 342-1913
(605) 348-2870
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11035
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9570740
—
SD
Enumeration date
07/13/2007
Last updated
07/13/2007
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