Organization
MENNO-OLIVET RETIREMENT HOME INC
Active
Other names
Menno-Olivet Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH ANN HEADLEY (ADMINISTRATOR)
(605) 387-5139
Entity
Organization
Contact information
Practice address
402 SOUTH PINE STREET, MENNO, SD 57045-0487
(605) 387-5139
(605) 387-2441
Mailing address
402 SOUTH PINE STREET, MENNO, SD 57045-0487
(605) 387-5139
(605) 387-2441
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
59462
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9570230
—
SD
Enumeration date
06/29/2010
Last updated
06/29/2010
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