Provider Demographics
NPI:1891190377
Name:GOODCARE ATHOME REHAB, LLC
Entity Type:Organization
Organization Name:GOODCARE ATHOME REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GABBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-988-4528
Mailing Address - Street 1:1000 N WEST AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-1314
Mailing Address - Country:US
Mailing Address - Phone:605-988-4528
Mailing Address - Fax:605-528-3058
Practice Address - Street 1:1000 N WEST AVE STE 210
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-1314
Practice Address - Country:US
Practice Address - Phone:605-231-2490
Practice Address - Fax:605-336-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS108908Medicare PIN