Organization
PARADISE PINES LLC
Active
Parent organization
PARADISE PINES LLC DBA MORNINGSTAR ALC
Other names
Morningstar ALC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARADISE PINES LLC DBA MORNINGSTAR ALC
Authorized official
MRS. JANICE KAY ZANDSTRA BSN RN (MEMBER FOR PARADISE PINES LLC)
(605) 342-2385
Entity
Organization
Contact information
Practice address
4110 WINFIELD STREET, RAPID CITY, SD 57701
(605) 348-2596
(605) 342-4119
Mailing address
429 ALTA VISTA DRIVE, RAPID CITY, SD 57701
(605) 342-2385
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
47202
SD
310400000X
Assisted Living Facility
51260
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9571202
—
SD
Enumeration date
08/24/2007
Last updated
08/24/2007
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