PINE LANE ESTATES LLC (NPI# 1104976356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104976356 |
| Entity Type | Organization |
| Organization Name | PINE LANE ESTATES LLC |
| Practice Address |
2905 Douglas Ave Yankton SD 57078 |
| Practice Telephone | 6056657255 |
| Practice Fax Number | 6056682730 |
| Mailing Telephone | 6056657255 |
| Mailing Fax Number | 6056682800 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. DEANNA JO LOECKER (ADMINISTRATOR) |
| Authorized Official Telephone | 6056657255 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 46906 | SD | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 9571690 | 05 |
| Street Address |
2905 DOUGLAS AVE |
| City | YANKTON |
| State | SD |
| Zip Code | 57078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063034015 | Yankton Aw | Assisted Living Facility | 2905 Douglas Ave, Yankton, SD 57078-5123 | 2020-05-13 |
| 1821360694 | Autumn Winds LLC | Hospice, Inpatient | 2905 Douglas Ave, Yankton, SD 57078-5123 | 2012-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033719661 | Jime Lynne Rivera | Psychiatry & Neurology | 708 E 21st Street, Yankton, SD 57078 | 2020-11-01 |
| 1043617210 | Kenneth Tomek | Dietitian, Registered | 2100 Broadway St, Yankton, SD 57078 | 2014-12-03 |
| 1932530276 | Jacqueline Ann Kelley | Nurse Practitioner | 1105 West 8th Street, Mount Marty College, Yankton, SD 57078 | 2013-12-12 |
| 1124363130 | Susan Kay Taecker | Occupational Therapist | 1502 Jo Ln, Yankton, SD 57078 | 2012-12-02 |
| 1295865178 | Dr Jon C Baumann Dds PC | Dentist | 809 Belfast Street, Yankton, SD 57078 | 2007-03-07 |
| 1306989090 | Gregory Scott Erickson | Internal Medicine | 501 Summit, Yankton, SD 57078 | 2007-02-14 |
| 1518029917 | Teresa M Henrickson | Counselor | 904 W 23rd St Ste 101, Heartland Psychological Services, Yankton, SD 57078 | 2006-12-14 |
| 1396805016 | Joseph G Blackinton | Psychologist | Heartland Psychological Services, 904 W 23rd St Ste 101, Yankton, SD 57078 | 2006-12-11 |
| 1942383468 | Deborah Jean Kachena | Social Worker | 610 W 23rd Street, Yankton, SD 57078 | 2006-10-21 |
| 1528155926 | Gary Allen Merkwan | Chiropractor | 2708 East South Dakota Highway 50, Yankton, SD 57078 | 2006-10-06 |
| Find all providers in zip 57078 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588277099 | Yankton Aw | Assisted Living Facility | 2903 Douglas Ave, Yankton, SD 57078-4888 | 2020-08-25 |
| 1063034015 | Yankton Aw | Assisted Living Facility | 2905 Douglas Ave, Yankton, SD 57078-5123 | 2020-05-13 |
| 1255662763 | Autumn Winds LLC | Assisted Living Facility | 300 E 6th St, Yankton, SD 57078-4000 | 2010-01-22 |
| 1235351719 | Prairie Homes Assisted Living LLC | Assisted Living Facility | 300 E 6th St, Yankton, SD 57078-4000 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760094122 | Mitchell Retirement | Assisted Living Facility | 2100 N Wisconsin St, Mitchell, SD 57301-1261 | 2020-08-18 |
| 1346897352 | Huron Sd Assisted Living Facility LLC | Assisted Living Facility | 1251 Arizona Ave Sw, Huron, SD 57350-3015 | 2019-08-23 |
| 1972076024 | Edgewood Rapid City LLC | Assisted Living Facility | 4001 Derby Lane, Rapid City, SD 57701 | 2019-01-10 |
| 1447722210 | Sturgis Assisted Living, LLC | Assisted Living Facility | 2065 Moose Dr, Sturgis, SD 57785-4003 | 2018-12-18 |
| 1326516501 | Edgewood Watertown Mc 2 LLC | Assisted Living Facility | 225 14 Ave Ne, Watertown, SD 57201 | 2018-11-06 |
| 1306336656 | Will Care Services, LLC | Assisted Living Facility | 4709 E 6th St, Sioux Falls, SD 57110-5851 | 2018-05-12 |
| 1538656400 | Viborg Retirement Living, Inc | Assisted Living Facility | 211 Peterson Drive, Viborg, SD 57070 | 2018-04-17 |
| 1770004996 | Edgewood Mitchell LLC | Assisted Living Facility | 501 East Spruce Street, Mitchell, SD 57301 | 2017-06-28 |
| 1760835052 | Rclalc,llc | Assisted Living Facility | 409 E Fairlane Dr, Rapid City, SD 57701-7207 | 2016-07-21 |
| 1730554577 | Edgewood Pierre LLC | Assisted Living Facility | 1950 E 4th St, Pierre, SD 57501-4201 | 2015-12-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.