Healthcare Provider Details

I. General information

NPI: 1770356560
Provider Name (Legal Business Name): INDEPENDENT HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1143 LINCOLN AVE SW
HURON SD
57350-3011
US

IV. Provider business mailing address

1143 LINCOLN AVE SW
HURON SD
57350-3011
US

V. Phone/Fax

Practice location:
  • Phone: 605-352-4663
  • Fax: 605-352-1373
Mailing address:
  • Phone: 605-352-4663
  • Fax: 605-352-1373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY KINGDON-REESE
Title or Position: EXECUTIVE DIRECTOR
Credential: MBHCA,BSN, RN
Phone: 605-352-4663