Organization
SPEARFISH HEALTHCARE, LLC
Active
Parent organization
MISSION HEALTHCARE, LLC
Other names
David M. Dorsett Healthcare Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSION HEALTHCARE, LLC
Authorized official
MR. THOMAS E. BOERBOOM (CHIEF OPERATING OFFICER)
(952) 873-7907
Entity
Organization
Contact information
Practice address
1020 NORTH 10TH STREET, SPEARFISH, SD 57783-2203
(605) 642-2716
(605) 722-0757
Mailing address
1020 NORTH 10TH STREET, SPEARFISH, SD 57783-2203
(605) 642-2716
(605) 722-0757
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10686
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150412
—
SD
01
—
85043
WELLMARK
SD
Enumeration date
07/06/2006
Last updated
04/14/2011
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