Organization
RAPID CITY HEALTHCARE, LLC
Active
Parent organization
MISSION HEALTHCARE, LLC
Other names
Fountain Springs Healthcare
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSION HEALTHCARE, LLC
Authorized official
MR. THOMAS E. BOERBOOM (CHIEF OPERATING OFFICER)
(952) 873-7907
Entity
Organization
Contact information
Practice address
2000 WESLEYAN BLVD, RAPID CITY, SD 57702-9340
(605) 343-3555
(605) 348-1979
Mailing address
2000 WESLEYAN BLVD, RAPID CITY, SD 57702-9340
(605) 343-3555
(605) 348-1979
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10723
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151302
—
SD
05
—
0151303
—
SD
Enumeration date
06/16/2005
Last updated
02/09/2011
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