Organization
KISMET ELK LLC
Active
Other names
Prairie Estates Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L. MOORE (CHIEF FINANCIAL OFFICER)
(605) 642-7736
Entity
Organization
Contact information
Practice address
600 SOUTH FRANKLIN ST, ELK POINT, SD 57025-0486
(605) 356-2622
Mailing address
PO BOX 486, 600 S. FRANKLIN, ELK POINT, SD 57025-0486
(605) 356-2622
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10615
SD
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821099102
—
SD
Enumeration date
08/09/2005
Last updated
06/29/2020
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