Provider Demographics
NPI:1598753196
Name:SUNSET MANOR INC.
Entity Type:Organization
Organization Name:SUNSET MANOR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-263-3318
Mailing Address - Street 1:129 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:IRENE
Mailing Address - State:SD
Mailing Address - Zip Code:57037
Mailing Address - Country:US
Mailing Address - Phone:605-263-3318
Mailing Address - Fax:
Practice Address - Street 1:129 CLAY ST
Practice Address - Street 2:
Practice Address - City:IRENE
Practice Address - State:SD
Practice Address - Zip Code:57037
Practice Address - Country:US
Practice Address - Phone:605-263-3318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10636314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0160110Medicaid
SD0160110Medicaid