Provider Demographics
NPI:1740932656
Name:PRESIDENTIAL PROPERTIES LLC
Entity type:Organization
Organization Name:PRESIDENTIAL PROPERTIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARALAMBOUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-425-2858
Mailing Address - Street 1:600 S HILL ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:SD
Mailing Address - Zip Code:57058-8707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 S HILL ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:SD
Practice Address - Zip Code:57058-8707
Practice Address - Country:US
Practice Address - Phone:605-425-2858
Practice Address - Fax:605-425-2871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility