Healthcare Provider Details
I. General information
NPI: 1336292754
Provider Name (Legal Business Name): OAHE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/19/2007
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
125 W PLEASANT DR SUITE #1
PIERRE SD
57501-2403
US
IV. Provider business mailing address
125 W PLEASANT DR SUITE #1
PIERRE SD
57501-2403
US
V. Phone/Fax
- Phone: 605-224-4501
- Fax: 605-224-9619
- Phone: 605-224-4501
- Fax: 605-224-9619
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | SD |
VIII. Authorized Official
Name: MR.
BRETT
ALAN
WHITE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 605-224-4501