Healthcare Provider Details

I. General information

NPI: 1598864498
Provider Name (Legal Business Name): BENNETT COUNTY SENIOR CITIZENS CENTER ASSOCIATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MAIN STREET
MARTIN SD
57551-0636
US

IV. Provider business mailing address

PO BOX 636
MARTIN SD
57551-0636
US

V. Phone/Fax

Practice location:
  • Phone: 605-685-6642
  • Fax: 605-685-6980
Mailing address:
  • Phone: 605-685-6642
  • Fax: 605-685-6980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: DONNA C. NOEL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 605-685-6642