- Enrollment id
- O20180627001613
- Enrollment state
- SD
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1467955682
- Multiple npi flag
- N
- Ccn
- 435004
- Associate id
- 1355697772
- Organization name
- ABERDEEN NURSING AND REHAB CENTER LLC
- Doing business as name
- PRAIRIE HEIGHTS HEALTHCARE
- Incorporation date
- 2018-01-11
- Incorporation state
- SD
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PRAIRIE HEIGHTS HEALTHCARE
- Affiliation entity name
- EDURO HEALTHCARE
- Affiliation entity id
- 193
- Address line 1
- 400 8TH AVE NW
- City
- ABERDEEN
- State
- SD
- Zip code
- 574012331