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General NPI Number Information
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NPI Number | 1083825707
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Entity Type | Organization
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Legal Business Name | ST. WILLIAM'S HOME
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 100 S 9TH ST
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City | MILBANK
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State | SD
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Zip | 57252-2105
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Country | US
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Telephone | 605-432-5811
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Fax | 605-432-3187
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Provider Business Mailing Address
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Address Line | 100 SOUTH 9TH STREET
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City | MILBANK
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State | SD
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Zip | 57252-2105
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Country | US
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Telephone | 605-432-5811
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Fax | 605-432-3187
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. ESTHER LEROUX
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Credential |
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Telephone | 605-432-3171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 10737
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 10649
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License Number State | SD
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