Organization
WILMOT CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNETTE GILBERTSON (BUSINESS MANAGER)
(605) 938-4418
Entity
Organization
Contact information
Practice address
501 4TH ST, WILMOT, SD 57279-2232
(605) 938-4418
(605) 938-4412
Mailing address
501 4TH ST, WILMOT, SD 57279-2232
(605) 938-4418
(605) 938-4412
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
10712
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4995108
BCBS PPO PROVIDER #
SD
Enumeration date
09/21/2006
Last updated
08/22/2020
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