Healthcare Provider Details

I. General information

NPI: 1568899425
Provider Name (Legal Business Name): SOUTH DAKOTA HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2013
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W RUSSELL ST
SIOUX FALLS SD
57104-1328
US

IV. Provider business mailing address

1400 W RUSSELL ST
SIOUX FALLS SD
57104-1328
US

V. Phone/Fax

Practice location:
  • Phone: 605-275-0070
  • Fax: 605-275-0071
Mailing address:
  • Phone: 605-275-0070
  • Fax: 605-275-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateSD
# 3
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number1568899425
License Number StateSD

VIII. Authorized Official

Name: MR. TONY L MAU
Title or Position: OWNER
Credential:
Phone: 605-275-0070