Organization
GOLDEN RIDGE VENTURES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG DERNIER (OWNER)
(660) 281-3180
Entity
Organization
Contact information
Practice address
200 MONTANA AVE, LEAD, SD 57754-1051
(605) 722-6380
(918) 960-9856
Mailing address
PO BOX 745, RAPID CITY, SD 57709-0745
(660) 281-3180
(918) 960-9856
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
41975
SD
Other
Enumeration date
09/08/2017
Last updated
09/08/2017
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