Healthcare Provider Details

I. General information

NPI: 1902363534
Provider Name (Legal Business Name): ALL ABOUT HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2019
Last Update Date: 03/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S FRED ST
EGAN SD
57024-2150
US

IV. Provider business mailing address

211 S FRED ST
EGAN SD
57024-2150
US

V. Phone/Fax

Practice location:
  • Phone: 605-351-5731
  • Fax:
Mailing address:
  • Phone: 605-351-5731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE MARIE TEN EYCK
Title or Position: OWNER
Credential:
Phone: 605-351-5731