Healthcare Provider Details

I. General information

NPI: 1881308005
Provider Name (Legal Business Name): FAMILY CONNECTIONS CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 E MONROE ST
RAPID CITY SD
57701-1323
US

IV. Provider business mailing address

457 EISENHOWER LN
BOX ELDER SD
57719-8142
US

V. Phone/Fax

Practice location:
  • Phone: 605-349-1880
  • Fax:
Mailing address:
  • Phone: 605-716-0422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: BRETT J SCHNEIDER
Title or Position: SERVICES AND SUPPORT ADMINISTRATOR
Credential: CHW
Phone: 605-716-0422