Healthcare Provider Details

I. General information

NPI: 1417445230
Provider Name (Legal Business Name): CENTERVILLE CARE & REHAB CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 VERMILLION ST
CENTERVILLE SD
57014-2168
US

IV. Provider business mailing address

500 VERMILLION ST
CENTERVILLE SD
57014-2168
US

V. Phone/Fax

Practice location:
  • Phone: 605-563-2251
  • Fax:
Mailing address:
  • Phone: 605-563-2251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateSD

VIII. Authorized Official

Name: CHAD STROSCHEIN
Title or Position: OWNER
Credential:
Phone: 605-670-9855