PARADISE PINES LLC NPI 1811180565

NPI Information

NPI: 1811180565
Provider Name: PARADISE PINES LLC

Doing Business As: MORNINGSTAR ALC

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

Address:
4110 WINFIELD STREET
RAPID CITY, SD
ZIP 57701
Phone: (605) 348-2596
Get Directions

PARADISE PINES LLC is an assisted living facility in Rapid City, 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. PARADISE PINES LLC NPI is 1811180565. The provider is registered as an organization entity type.
The provider Is Doing Business As Morningstar Alc.

The provider's business location address is:

4110 WINFIELD STREET
RAPID CITY, SD
ZIP 57701
Phone: (605) 348-2596
Fax: (605) 342-4119

The provider's authorized official is Janice Kay Zandstra .
The authorized official title is Member For Paradise Pines Llc and has the following contact phone number (605) 342-2385.

The CLIA number assigned to this NPI record is 43D1069313 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2007 and was last updated on 8/24/2007.

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
1	310400000X	Assisted Living Facility		51260	SOUTH DAKOTA	No
2	310400000X	Assisted Living Facility		47202	SOUTH DAKOTA	Yes

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
1	9571202	MEDICAID	SOUTH 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: 11/14/2023

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