Healthcare Provider Details

I. General information

NPI: 1437086618
Provider Name (Legal Business Name): SOUTH DAKOTA ACHIEVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 S WESTERN AVE
SIOUX FALLS SD
57105-6620
US

IV. Provider business mailing address

4100 S WESTERN AVE
SIOUX FALLS SD
57105-6620
US

V. Phone/Fax

Practice location:
  • Phone: 605-444-9900
  • Fax:
Mailing address:
  • Phone: 605-444-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: STACY JEAN FLAHAVEN
Title or Position: CONTROLLER
Credential:
Phone: 605-444-9835