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NPI Code Detail

MEDICARE: HEARTLAND SENIOR LIVING-RUSHMORE, LLC

MEDICARE: HEARTLAND SENIOR LIVING-RUSHMORE, LLC
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
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1225875339
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTLAND SENIOR LIVING-RUSHMORE, LLC
Provider Business Mailing Address
First Line : 330 KNOLLWOOD DR
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-0644
Country : US
Telephone Number : 605-721-0269
Fax Number : 605-716-1588
Provider Business Practice Location Address
First Line : 409 E FAIRLANE DR
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-7207
Country : US
Telephone Number : 605-399-1551
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JESIKA LYN FLOYD
Credential :
Telephone Number : 605-200-9110
Provider Enumeration Date : 07/15/2024
Last Update Date : 07/15/2024

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Directions to “HEARTLAND SENIOR LIVING-RUSHMORE, LLC ” Practice Location

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