Healthcare Provider Details

I. General information

NPI: 1558560904
Provider Name (Legal Business Name): CHILDREN'S CARE HOSPITAL AND SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 W 18TH ST
SIOUX FALLS SD
57104-4707
US

IV. Provider business mailing address

2501 W 26TH ST
SIOUX FALLS SD
57105-2446
US

V. Phone/Fax

Practice location:
  • Phone: 605-444-9500
  • Fax:
Mailing address:
  • Phone: 605-444-9500
  • Fax: 605-444-9601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number10562
License Number StateSD

VIII. Authorized Official

Name: MS. DIANNA RAJSKI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 605-444-9500