Healthcare Provider Details

I. General information

NPI: 1851560189
Provider Name (Legal Business Name): SILVER PLAINS ASSISTED LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 PARK AVE S
LAKE PRESTON SD
57249-2144
US

IV. Provider business mailing address

610 PARK AVE S
LAKE PRESTON SD
57249-2144
US

V. Phone/Fax

Practice location:
  • Phone: 605-847-4800
  • Fax:
Mailing address:
  • Phone: 605-847-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number55956
License Number StateSD

VIII. Authorized Official

Name: MRS. TONYA BUMANN
Title or Position: ADMIN/DIRECTOR OF CARE
Credential: RN
Phone: 605-847-4800