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SALEM MENNONITE HOME FOR THE AGED NPI 1235223942


NPI Information

NPI: 1235223942
Provider Name: SALEM MENNONITE HOME FOR THE AGED

Doing Business As: SALEM MENNONITE HOME

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 43D1000525

Address:
106 W. 7TH STREET
FREEMAN, SD
ZIP 57029
Phone: (605) 925-4994
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SALEM MENNONITE HOME FOR THE AGED is an assisted living facility in Freeman, SD. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. SALEM MENNONITE HOME FOR THE AGED NPI is 1235223942. The provider is registered as an organization entity type.
The provider Is Doing Business As Salem Mennonite Home.

The provider's business location address is:

106 W. 7TH STREET
FREEMAN, SD
ZIP 57029-319
Phone: (605) 925-4994
Fax: (605) 925-4764

The provider's authorized official is Stewart Hofer .
The authorized official title is Administrator and has the following contact phone number (605) 925-4994.

The CLIA number assigned to this NPI record is 43D1000525 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility10622SOUTH DAKOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
19566630MEDICAIDSOUTH DAKOTA
2957133MEDICAIDSOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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