Provider Demographics
NPI:1174605836
Name:PONDEROSA APARTMENTS, INC
Entity type:Organization
Organization Name:PONDEROSA APARTMENTS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-642-6613
Mailing Address - Street 1:430 ORIOLE DR
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-1538
Mailing Address - Country:US
Mailing Address - Phone:605-642-6613
Mailing Address - Fax:605-642-6421
Practice Address - Street 1:430 ORIOLE DR
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1538
Practice Address - Country:US
Practice Address - Phone:605-642-6613
Practice Address - Fax:605-642-6421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals