SOUTHEASTERN BEHAVIORAL HEALTHCARE NPI 1114002573

NPI Information

NPI: 1114002573
Provider Name: SOUTHEASTERN BEHAVIORAL HEALTHCARE
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 43D2199516

Address:
2000 S SUMMIT AVE
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 336-0510
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SOUTHEASTERN BEHAVIORAL HEALTHCARE is a mental health (including community mental health center) clinic center in Sioux Falls, SD. SOUTHEASTERN BEHAVIORAL HEALTHCARE NPI is 1114002573. The provider is registered as an organization entity type.

The provider's business location address is:

2000 S SUMMIT AVE
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 336-0510

The provider's authorized official is Robyn Brower .
The authorized official title is Business Manager and has the following contact phone number (605) 336-0510.

The CLIA number assigned to this NPI record is 43D2199516 - other - dd residential program with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/26/2006 and was last updated on 6/21/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder		SOUTH DAKOTA	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1002113	OTHER	SOUTH DAKOTA	BLUE CROSS & BLUE SHIELD
2	5200020	MEDICAID	SOUTH DAKOTA
3	=========	OTHER	SOUTH DAKOTA	DAKOTACARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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