MEDICARE: DELL RAPIDS NRSG. HOME INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	313M00000X	Nursing Facility/Intermediate Care Facility	10613	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225074164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELL RAPIDS NRSG. HOME INC.

Provider Business Mailing Address
First Line	:	1400 THRESHER DR
Second Line	:
City	:	DELL RAPIDS
State	:	SD
Zip	:	57022-1049
Country	:	US
Telephone Number	:	605-428-5478
Fax Number	:	605-428-4521

Provider Business Practice Location Address
First Line	:	1400 THRESHER DR
Second Line	:
City	:	DELL RAPIDS
State	:	SD
Zip	:	57022-1049
Country	:	US
Telephone Number	:	605-428-5478
Fax Number	:	605-428-4521

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LINDA GAIL LJUNGGREN
Credential	:
Telephone Number	:	605-428-5478

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	08/22/2020

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