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General NPI Number Information
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NPI Number | 1689222481
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Entity Type | Organization
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Legal Business Name | BRIDGEWATER NURSING HOME CORPORATION
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 08/27/2019
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Provider Practice Location Address
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Address Line | 901 N MAIN AVE
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City | BRIDGEWATER
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State | SD
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Zip | 57319-2004
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Country | US
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Telephone | 605-729-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 901 N MAIN AVE
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City | BRIDGEWATER
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State | SD
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Zip | 57319-2004
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Country | US
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Telephone | 605-729-2525
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHAD STROSCHEIN
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Credential |
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Telephone | 605-670-9855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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