Provider Demographics
NPI:1447474192
Name:MORNING STAR FAMILY MINISTRIES, INC.
Entity type:Organization
Organization Name:MORNING STAR FAMILY MINISTRIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACTING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:KOCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-685-6710
Mailing Address - Street 1:103 EAST STATE ST.
Mailing Address - Street 2:P O BOX 845
Mailing Address - City:MARTIN
Mailing Address - State:SD
Mailing Address - Zip Code:57551-0845
Mailing Address - Country:US
Mailing Address - Phone:605-685-6710
Mailing Address - Fax:605-685-6714
Practice Address - Street 1:103 EAST STATE ST.
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:SD
Practice Address - Zip Code:57551-0845
Practice Address - Country:US
Practice Address - Phone:605-685-6710
Practice Address - Fax:605-685-6714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5000350Medicaid