Organization
EASTERN STAR HOME OF SOUTH DAKOTA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY A RICE (ADMINISTRATOR)
(605) 472-0658
Entity
Organization
Contact information
Practice address
126 W 12TH AVE, REDFIELD, SD 57469-1522
(605) 472-0658
(605) 472-3590
Mailing address
PO BOX 150, REDFIELD, SD 57469-0150
(605) 472-0658
(605) 472-3590
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10670
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150120
—
SD
Enumeration date
01/09/2007
Last updated
08/22/2020
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