Provider Demographics
NPI:1568899425
Name:SOUTH DAKOTA HOME CARE, INC.
Entity Type:Organization
Organization Name:SOUTH DAKOTA HOME CARE, INC.
Other - Org Name:RIGHT AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-275-0070
Mailing Address - Street 1:1400 W RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-1328
Mailing Address - Country:US
Mailing Address - Phone:605-275-0070
Mailing Address - Fax:605-275-0071
Practice Address - Street 1:601 S CLIFF AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-5276
Practice Address - Country:US
Practice Address - Phone:605-275-0070
Practice Address - Fax:605-275-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X
SD253Z00000X
SD1568899425333300000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No333300000XSuppliersEmergency Response System Companies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1568899425Medicaid