Healthcare Provider Details

I. General information

NPI: 1225915481
Provider Name (Legal Business Name): PP6 MADISON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 NW 1ST ST
MADISON SD
57042-2884
US

IV. Provider business mailing address

211 NW 1ST ST
MADISON SD
57042-2884
US

V. Phone/Fax

Practice location:
  • Phone: 605-556-0160
  • Fax:
Mailing address:
  • Phone: 605-556-0160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS J SCHOCHENMAIER
Title or Position: BUSINESS OPERATIONS MANAGER
Credential:
Phone: 605-359-5813