PARADISE PINES LLC; NPI #1811180565

Contact Information

PARADISE PINES LLC

4110 WINFIELD STREET
RAPID CITY, SD 57701

Phone: 605-348-2596
Fax: 605-342-4119
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Assisted Living Facility	310400000X

Indicates primary specialty

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NPI Profile & details for PARADISE PINES LLC

NPI Number 1811180565

LBN Legal business name PARADISE PINES LLC

Authorized official JANICE ZANDSTRA - (MEMBER FOR PARADISE PINES LLC)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 08/24/2007

Last updated 08/24/2007 - About 19 years ago

Identifiers

SD	License #	47202
SD	License #	51260
SD	Medicaid	9571202

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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