Organization
PRAIRIE VIEW RETIREMENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIRGINIA JEAN BANEK (OWNER)
(605) 778-6711
Entity
Organization
Contact information
Practice address
313 S WATER ST, KIMBALL, SD 57355-2217
(605) 778-6711
(605) 778-6718
Mailing address
313 S WATER ST, KIMBALL, SD 57355-2217
(605) 778-6711
(605) 778-6718
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10762
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9571480
—
SD
Enumeration date
01/05/2007
Last updated
08/22/2020
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