Organization
BETHESDA HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A ROGERS (ADMINISTRATOR)
(605) 345-3331
Entity
Organization
Contact information
Practice address
129 W HIGHWAY 12, WEBSTER, SD 57274-1000
(605) 345-3331
(605) 345-3325
Mailing address
129 W HIGHWAY 12, WEBSTER, SD 57274-1000
(605) 345-3331
(605) 345-3325
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10706
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150280
—
SD
01
—
85071
WELLMARK BCBS
SD
Enumeration date
06/30/2005
Last updated
03/11/2010
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