Organization
WOONSOCKET HEALTHCARE, LLC
Active
Other names
Prairie View Healthcare Community
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS BOERBOOM (PRESIDENT)
(952) 873-7977
Entity
Organization
Contact information
Practice address
401 S 1ST AVE, WOONSOCKET, SD 57385
(605) 796-4467
(605) 796-4497
Mailing address
4420 VALLEY VIEW RD, STE 201, EDINA, MN 55424-1870
(952) 873-7907
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10714
SD
Other
Enumeration date
09/09/2005
Last updated
02/17/2017
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