Healthcare Provider Details

I. General information

NPI: 1053308122
Provider Name (Legal Business Name): WARD ENTERPRISES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 PARKWAY
HUDSON SD
57034
US

IV. Provider business mailing address

PO BOX 486
HUDSON SD
57034-0486
US

V. Phone/Fax

Practice location:
  • Phone: 605-984-2244
  • Fax:
Mailing address:
  • Phone: 605-984-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number10632
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0150250
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer

VIII. Authorized Official

Name: MRS. CHARLIE WARD
Title or Position: OWNER
Credential: NHA
Phone: 605-670-0199