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General NPI Number Information
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NPI Number | 1871497511
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Entity Type | Organization
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Legal Business Name | COMMUNITY LIVING HOME
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 2220 S GRINNELL AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57106-5106
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Country | US
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Telephone | 605-789-0732
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Fax |
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Provider Business Mailing Address
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Address Line | 2220 S GRINNELL AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57106-5106
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Country | US
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Telephone | 605-789-0732
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABEL USHA ARGO
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Credential |
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Telephone | 605-789-0732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | NULL
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