Healthcare Provider Details

I. General information

NPI: 1538656798
Provider Name (Legal Business Name): COLTON RETIREMENT LIVING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 04/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 E 1ST ST
COLTON SD
57018-2137
US

IV. Provider business mailing address

24437 474TH AVE
DELL RAPIDS SD
57022-5306
US

V. Phone/Fax

Practice location:
  • Phone: 605-446-3606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

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