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General NPI Number Information
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NPI Number | 1568347474
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Entity Type | Organization
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Legal Business Name | BELLE ADULT DAY AND SENIOR SERVICES, LLC
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 10905 SOURDOUGH RD STE 20
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City | BELLE FOURCHE
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State | SD
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Zip | 57717-6117
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Country | US
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Telephone | 605-723-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 10905 SOURDOUGH RD STE 20
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City | BELLE FOURCHE
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State | SD
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Zip | 57717-6117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH KULLERD
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Credential | MD
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Telephone | 605-723-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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