COUNTRYSIDE INN ASSISTED LIVING & MEMORY CARE
NPI 1871600759
Assisted Living Facility in Rosholt, SD

Active since August 24, 2006CLIA 43D1064935 · Waiver
208 PRAIRIE AVE, ROSHOLT, SD 57260(605) 537-4588(605) 537-4890 Get Directions Write a Review

NPPES record last updated: August 24, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Countryside Inn Assisted Living & Memory Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRYSIDE INN ASSISTED LIVING & MEMORY CARE (NPI 1871600759) is a healthcare organization registered as an assisted living facility in Rosholt, South Dakota and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through February 15, 2027 and lists Charles William Vandeputte, Owner - Operator, as its authorized official.

NPPES Registry Identity

NPI1871600759
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameROSHOLT COUNTRY INN
Location Address208 PRAIRIE AVERosholt, SD 57260-0218
Mailing Address208 Prairie Ave, Po Box 218Rosholt, SD 57260-0218 · (605) 537-4588 · Fax (605) 537-4890
Fax(605) 537-4890
Organization SubpartNo
Authorized OfficialCharles William VandeputteOwner - Operator · (605) 537-4588
Enumeration DateAugust 24, 2006
Last NPPES UpdateAugust 24, 2007
NPI 1871600759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License Licensed in SD · 53737
Definition
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.
Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X · License 53737 (SD)
208 PRAIRIE AVE, Rosholt, SD 57260

Other Names 1

Doing Business AsCountryside Inn Assisted Living & Memory Care

Other Identifiers 1

Medicaid9570820SD

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 43D1064935

Countryside Inn Assisted And · Rosholt, SD
Active · expires Feb 15, 2027
CLIA Number43D1064935
Laboratory TypeAssisted Living Facility
Certificate Effective DateFebruary 16, 2025
Certificate Expiration DateFebruary 15, 2027
Laboratory DirectorDavid Brandell
Laboratory Phone(605) 537-4588
Laboratory LocationCountryside Inn Assisted And208 Prarie Avenue, Rosholt, SD 57260
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rosholt Country Inn's NPI number?

The NPI number for Rosholt Country Inn is 1871600759. It was assigned to this organization in the NPPES registry on August 24, 2006. The provider is doing business as Countryside Inn Assisted Living & Memory Care.

Where is Rosholt Country Inn located?

Rosholt Country Inn is located at 208 Prairie Ave, Rosholt, SD 57260. The listed phone number is (605) 537-4588.

What is Rosholt Country Inn's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Rosholt Country Inn hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 43D1064935) is associated with this NPI, valid through February 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Rosholt Country Inn was last updated on August 24, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.