Healthcare Provider Details

I. General information

NPI: 1639368517
Provider Name (Legal Business Name): SISSETON SCHOOL DISTRICT 54 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 8TH AVENUE WEST
SISSETON SD
57262-1262
US

IV. Provider business mailing address

516 8TH AVENUE WEST
SISSETON SD
57262-1262
US

V. Phone/Fax

Practice location:
  • Phone: 605-698-7613
  • Fax: 605-698-3032
Mailing address:
  • Phone: 605-698-7613
  • Fax: 605-698-3032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN J SCHULTE
Title or Position: SUPERINTENDENT
Credential: PHD
Phone: 605-698-7613