Provider Demographics
NPI:1952648172
Name:ELK POINT HEALTHCARE #2, LLC
Entity Type:Organization
Organization Name:ELK POINT HEALTHCARE #2, LLC
Other - Org Name:WEL-LIFE ASSISTED LIVING AT ELK POINT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLGARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-873-7977
Mailing Address - Street 1:600 E LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ELK POINT
Mailing Address - State:SD
Mailing Address - Zip Code:57025-2284
Mailing Address - Country:US
Mailing Address - Phone:605-356-2774
Mailing Address - Fax:
Practice Address - Street 1:600 E LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ELK POINT
Practice Address - State:SD
Practice Address - Zip Code:57025-2284
Practice Address - Country:US
Practice Address - Phone:605-356-2774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD41022310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility