Provider Demographics
NPI:1548599350
Name:MORGAN LANE VILLAGE
Entity Type:Organization
Organization Name:MORGAN LANE VILLAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF MANAGEMENT FIRM
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEIERHENRY
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:605-275-4747
Mailing Address - Street 1:315 S PHILLIPS AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-6318
Mailing Address - Country:US
Mailing Address - Phone:605-275-4747
Mailing Address - Fax:605-336-2593
Practice Address - Street 1:540 MORGAN LANE
Practice Address - Street 2:
Practice Address - City:TEA
Practice Address - State:SD
Practice Address - Zip Code:57104
Practice Address - Country:US
Practice Address - Phone:605-275-1200
Practice Address - Fax:605-275-1201
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEA HRC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD61559310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD61559OtherSD DOH LICENSE