Healthcare Provider Details

I. General information

NPI: 1639218084
Provider Name (Legal Business Name): HOMECARE SERVICES OF SOUTH DAKOTA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 COTEAU ST
PIERRE SD
57501-3189
US

IV. Provider business mailing address

316 COTEAU ST
PIERRE SD
57501-3189
US

V. Phone/Fax

Practice location:
  • Phone: 605-224-2273
  • Fax: 605-224-9006
Mailing address:
  • Phone: 605-224-2273
  • Fax: 605-224-9006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberCLASS B PARAPROFESSI
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateSD

VII. Legacy identifiers

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

VIII. Authorized Official

Name: ROBERT BOEHMER
Title or Position: AGENCY DIRECTOR
Credential:
Phone: 605-224-2273