Healthcare Provider Details

I. General information

NPI: 1376087148
Provider Name (Legal Business Name): PARK PLACE CARE AND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 S 2ND ST
MILBANK SD
57252-3321
US

IV. Provider business mailing address

1105 S 2ND ST
MILBANK SD
57252-3321
US

V. Phone/Fax

Practice location:
  • Phone: 605-432-4556
  • Fax:
Mailing address:
  • Phone: 605-432-4556
  • 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: JOSEPH SCHWARTZ
Title or Position: MANAGER
Credential:
Phone: 201-635-1195