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Organization

THE VICTORIAN ASSISTED LIVING HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LAVON JEAN HUNEKE RN (MANAGER)
(605) 342-1913
Entity
Organization

Contact information

Practice address
1321 COLUMBUS ST, RAPID CITY, SD 57701-2524
(605) 342-1913
(605) 348-2870
Mailing address
1321 COLUMBUS ST, RAPID CITY, SD 57701-2524
(605) 342-1913
(605) 348-2870

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11035
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9570740
SD
Enumeration date
07/13/2007
Last updated
07/13/2007
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