Healthcare Provider Details

I. General information

NPI: 1194885723
Provider Name (Legal Business Name): LUTHERAN SOCIAL SERVICES OF SOUTH DAKOTA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 E 41ST ST SUITE 200
SIOUX FALLS SD
57105-6053
US

IV. Provider business mailing address

705 E 41ST ST SUITE 200
SIOUX FALLS SD
57105-6053
US

V. Phone/Fax

Practice location:
  • Phone: 605-444-7500
  • Fax: 605-444-7540
Mailing address:
  • Phone: 605-444-7500
  • Fax: 605-444-7540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number97304
License Number StateSD
# 4
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number97302
License Number StateSD
# 5
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number97340
License Number StateSD
# 6
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: STACI DANELLE JONSON
Title or Position: VICE PRESIDENT
Credential:
Phone: 605-389-8468