Healthcare Provider Details

I. General information

NPI: 1356486534
Provider Name (Legal Business Name): CATHOLIC FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 11/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 15TH AVE SE
ABERDEEN SD
57401-7505
US

IV. Provider business mailing address

523 N DULUTH AVE
SIOUX FALLS SD
57104-2714
US

V. Phone/Fax

Practice location:
  • Phone: 605-988-3775
  • Fax: 605-988-3747
Mailing address:
  • Phone: 605-988-3775
  • Fax: 605-988-3747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2057
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2040
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1065
License Number StateSD

VIII. Authorized Official

Name: DOROTHY EILEEN GARCIA
Title or Position: FINANCE MANAGER
Credential:
Phone: 605-988-3775