Healthcare Provider Details

I. General information

NPI: 1851706683
Provider Name (Legal Business Name): SESDAC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 11/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E CHERRY ST
VERMILLION SD
57069-1606
US

IV. Provider business mailing address

1314 E CHERRY ST
VERMILLION SD
57069-1606
US

V. Phone/Fax

Practice location:
  • Phone: 605-624-4419
  • Fax: 605-624-7375
Mailing address:
  • Phone: 605-624-4419
  • Fax: 605-624-7375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: LINDA M. PAULSON
Title or Position: BUSINESS MANAGER
Credential:
Phone: 605-624-4419