Organization
TCC HOLDINGS CORPORATION
Active
Other names
Diamond Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
HOWIE GROFF (PRESIDENT)
(952) 888-2923
Entity
Organization
Contact information
Practice address
901 N MAIN AVE, BRIDGEWATER, SD 57319-2004
(605) 729-2525
Mailing address
901 N MAIN AVE, PO BOX 300, BRIDGEWATER, SD 57319-2004
(605) 729-2525
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
49737
SD
314000000X
Skilled Nursing Facility
Primary
10597
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160352
—
SD
01
—
85115
BLUE CROSS BLUE SHIELD
SD
05
—
9566750
—
SD
05
—
9566770
—
SD
05
—
9570430
—
SD
05
—
9570580
—
SD
Enumeration date
10/10/2005
Last updated
06/27/2012
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