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General NPI Number Information
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NPI Number | 1659235968
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Entity Type | Organization
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Legal Business Name | CROW CREEK DEPARTMENT OF PUBLIC SAFETY
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 206 E. SAMBOY DRIVE 206 E. SAMBOY
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City | FORT THOMPSON
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State | SD
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Zip | 57339-0409
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Country | US
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Telephone | 605-245-2779
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Fax | 605-245-2182
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Provider Business Mailing Address
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Address Line | PO BOX 409 206 E. SAMBOY
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City | FORT THOMPSON
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State | SD
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Zip | 57339-0409
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Country | US
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Telephone | 605-478-0431
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | THOMAS WAYNE THOMPSON
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Credential |
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Telephone | 605-245-2779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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