Organization
WAKONDA SUPERVISED LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY MCMANUS (ADMINISTRATOR)
(605) 267-2081
Entity
Organization
Contact information
Practice address
515 OHIO ST, WAKONDA, SD 57073-2013
(605) 267-2081
Mailing address
515 OHIO ST, WAKONDA, SD 57073-2013
(605) 267-2081
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11048
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9572190
—
SD
Enumeration date
05/22/2007
Last updated
08/22/2020
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