Provider Demographics
NPI:1740695675
Name:NORTHEAST CARE AND REHABILITATION CENTER INC
Entity type:Organization
Organization Name:NORTHEAST CARE AND REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-537-4272
Mailing Address - Street 1:85 S 1ST AVE
Mailing Address - Street 2:PO BOX 108
Mailing Address - City:ROSHOLT
Mailing Address - State:SD
Mailing Address - Zip Code:57260
Mailing Address - Country:US
Mailing Address - Phone:605-537-4272
Mailing Address - Fax:605-537-4385
Practice Address - Street 1:85 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:ROSHOLT
Practice Address - State:SD
Practice Address - Zip Code:57260
Practice Address - Country:US
Practice Address - Phone:605-537-4272
Practice Address - Fax:605-537-4385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility