Provider Demographics
NPI:1336744242
Name:HURON VT LLC
Entity Type:Organization
Organization Name:HURON VT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LETHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIENAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-689-0439
Mailing Address - Street 1:300 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-4000
Mailing Address - Country:US
Mailing Address - Phone:605-689-0439
Mailing Address - Fax:605-689-2035
Practice Address - Street 1:50 7TH ST SE
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-2803
Practice Address - Country:US
Practice Address - Phone:605-689-0439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility