Provider Demographics
NPI:1265651418
Name:COMPLETE HOME CARE, INC.
Entity type:Organization
Organization Name:COMPLETE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:YEE-LAI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:605-338-9383
Mailing Address - Street 1:1104 W RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-1323
Mailing Address - Country:US
Mailing Address - Phone:605-338-9383
Mailing Address - Fax:
Practice Address - Street 1:1104 W RUSSELL ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-1323
Practice Address - Country:US
Practice Address - Phone:605-338-9383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1001527251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD8503700Medicaid
SD0399220001Medicare ID - Type UnspecifiedHOME INFUSION
SDS77838Medicare PIN