Healthcare Provider Details

I. General information

NPI: 1396687422
Provider Name (Legal Business Name): MIDLAND BROTHERHOOD HOMECARE SERVICES LLC (MIDBRO)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 W 11TH ST
SIOUX FALLS SD
57104-3523
US

IV. Provider business mailing address

707 W 11TH ST
SIOUX FALLS SD
57104-3523
US

V. Phone/Fax

Practice location:
  • Phone: 605-303-8290
  • Fax:
Mailing address:
  • Phone: 605-303-8290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: KUN BILIU GARBANG
Title or Position: DIRECTOR
Credential: GARBANG
Phone: 605-303-8290