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Organization

BETHEL LUTHERAN HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES T IVERSON (ADMINISTRATOR)
(605) 256-4936
Entity
Organization

Contact information

Practice address
1001 S EGAN AVE, MADISON, SD 57042-3336
(605) 256-4539
(605) 256-4007
Mailing address
1001 S EGAN AVE, MADISON, SD 57042-3336
(605) 256-4539
(605) 256-4007

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10644
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0150390
SD
Enumeration date
11/07/2005
Last updated
08/22/2020
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