NPI: 1114204096 · SPEARFISH, SD 57783 · Assisted Living Facility · NPI assigned 11/07/2011
| Authorized Official | DEROSIER, KIMBERLY (ADMINISTRATOR/OWNER) |
| NPI Enumeration Date | 11/07/2011 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 14 | $11K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2031 | Assisted living; waiver, per diem | 14 | 12 | $11K |