Healthcare Provider Details

I. General information

NPI: 1295878205
Provider Name (Legal Business Name): ADDICTION RECOVERY CENTERS OF THE BLACK HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 HAINES AVE
RAPID CITY SD
57701-0710
US

IV. Provider business mailing address

1520 HAINES AVE
RAPID CITY SD
57701-0710
US

V. Phone/Fax

Practice location:
  • Phone: 605-716-7841
  • Fax: 605-718-0404
Mailing address:
  • Phone: 605-716-7841
  • Fax: 605-718-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number101
License Number StateSD

VII. Legacy identifiers

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

# 1
Identifier101
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerDIVISION OF ALCOHOL AND D
# 2
Identifier5006010
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer

VIII. Authorized Official

Name: MRS. JULIE BIRNER
Title or Position: DIRECTOR
Credential: MSW, CSW, LAC, QMHP
Phone: 605-716-7841