Healthcare Provider Details

I. General information

NPI: 1366369290
Provider Name (Legal Business Name): MRSH SPEARFISH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 N 10TH ST
SPEARFISH SD
57783-2203
US

IV. Provider business mailing address

1020 N 10TH ST
SPEARFISH SD
57783-2203
US

V. Phone/Fax

Practice location:
  • Phone: 605-642-2716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ALICIA CEPEDA
Title or Position: SENIOR LEGAL/RISK MANAGER
Credential:
Phone: 385-342-5175