Healthcare Provider Details

I. General information

NPI: 1841622255
Provider Name (Legal Business Name): PUZZLED PATHWAYS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 S MINNESOTA AVE
SIOUX FALLS SD
57108-2707
US

IV. Provider business mailing address

5000 S MINNESOTA AVE
SIOUX FALLS SD
57108-2707
US

V. Phone/Fax

Practice location:
  • Phone: 605-271-1237
  • Fax: 605-271-1237
Mailing address:
  • Phone: 605-271-1237
  • Fax: 605-271-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberR028205
License Number StateSD

VIII. Authorized Official

Name: ANN MARIE MECHTENBERG
Title or Position: OWNER
Credential: RN
Phone: 605-271-1237