Healthcare Provider Details

I. General information

NPI: 1184610339
Provider Name (Legal Business Name): MORNINGSIDE MANOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CHURCH ST.
ALCESTER SD
54001-0500
US

IV. Provider business mailing address

101 CHURCH STREET
ALCESTER SD
54001-0500
US

V. Phone/Fax

Practice location:
  • Phone: 605-934-2011
  • Fax: 605-934-9923
Mailing address:
  • Phone: 605-934-2011
  • Fax: 605-934-9923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number10591
License Number StateSD

VIII. Authorized Official

Name: MRS. DESIREE DUNCAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 605-934-2011