Healthcare Provider Details

I. General information

NPI: 1699616524
Provider Name (Legal Business Name): GROWTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N DAKOTA AVE
SIOUX FALLS SD
57104-6037
US

IV. Provider business mailing address

300 N DAKOTA AVE STE 204
SIOUX FALLS SD
57104-6023
US

V. Phone/Fax

Practice location:
  • Phone: 701-660-8084
  • Fax:
Mailing address:
  • Phone: 605-740-5123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS BEATRICE N KOON II
Title or Position: MANAGER
Credential: KOON
Phone: 701-660-8084