Healthcare Provider Details

I. General information

NPI: 1982149027
Provider Name (Legal Business Name): NATIVECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2016
Last Update Date: 12/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 EAST 3RD
MISSION SD
57555-0403
US

IV. Provider business mailing address

PO BOX 403
MISSION SD
57555-0403
US

V. Phone/Fax

Practice location:
  • Phone: 605-828-4441
  • Fax:
Mailing address:
  • Phone: 605-828-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ED PARSELLS
Title or Position: DIRECTOR
Credential: LAC
Phone: 605-220-6587