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General NPI Number Information
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NPI Number | 1336092873
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Entity Type | Individual
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Provider Name | MANUEL VILLAGRANA ACT
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Gender | Male
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 112 N CHICAGO ST
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City | HOT SPRINGS
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State | SD
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Zip | 57747-1632
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Country | US
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Telephone | 605-745-6300
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Fax | 605-718-0404
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Provider Business Mailing Address
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Address Line | 1520 HAINES AVE STE 6
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City | RAPID CITY
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State | SD
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Zip | 57701-0710
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Country | US
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Telephone | 605-716-7841
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Fax | 605-718-0404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 8712
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License Number State | SD
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