Healthcare Provider Details

I. General information

NPI: 1144158437
Provider Name (Legal Business Name): NORTH STAR RESPITE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 VALLEY DR APT 15
RAPID CITY SD
57703-4854
US

IV. Provider business mailing address

PO BOX 263
BOX ELDER SD
57719-0263
US

V. Phone/Fax

Practice location:
  • Phone: 317-640-4150
  • Fax:
Mailing address:
  • Phone: 317-640-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR MOWERY
Title or Position: OWNER
Credential:
Phone: 317-640-4150