Organization
PINE LANE ESTATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEANNA JO LOECKER (ADMINISTRATOR)
(605) 665-7255
Entity
Organization
Contact information
Practice address
2905 DOUGLAS AVE, YANKTON, SD 57078
(605) 665-7255
(605) 668-2730
Mailing address
2905 DOUGLAS AVE, YANKTON, SD 57078
(605) 665-7255
(605) 668-2800
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
46906
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9571690
—
SD
Enumeration date
01/11/2007
Last updated
08/22/2020
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