Organization
MENNO-OLIVET RETIREMENT HOME INC
Active
Other names
MENNO-OLIVET CARE CENTER
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
PO BOX 487, MENNO, SD 57045-0487
(605) 387-5139
(605) 387-2441
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10648
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160260
—
SD
Enumeration date
11/07/2005
Last updated
06/22/2010
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