Healthcare Provider Details

I. General information

NPI: 1154015873
Provider Name (Legal Business Name): AMERICAN BAPTIST OF THE MIDWEST FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3408 W RALPH ROGERS RD STE 200
SIOUX FALLS SD
57108-2683
US

IV. Provider business mailing address

3408 W RALPH ROGERS RD STE 200
SIOUX FALLS SD
57108-2683
US

V. Phone/Fax

Practice location:
  • Phone: 605-231-8141
  • Fax: 605-373-0088
Mailing address:
  • Phone: 605-231-8141
  • Fax: 605-373-0088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: REBAKAH B DEHAAI
Title or Position: DIRECTOR OF HOME CARE
Credential:
Phone: 605-231-8141