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NPI 1750259776

NPI 1750259776 : WCC-BHS COMMUNITY HEALTH WORKER : WAGNER, SD

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General NPI Number Information
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    NPI Number           |    1750259776
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    Entity Type          |    Organization 
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    Legal Business Name  |    WCC-BHS COMMUNITY HEALTH WORKER 
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Dates
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    Enumeration Date     |    10/29/2025
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    Last Update Date     |    10/29/2025
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Provider Practice Location Address
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    Address Line         |    513 3RD ST SW 
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    City                 |    WAGNER
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    State                |    SD
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    Zip                  |    57380-9675
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    Country              |    US
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    Telephone            |    605-384-3611
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    Fax                  |    605-384-3232
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Provider Business Mailing Address
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    Address Line         |    513 3RD ST SW 
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    City                 |    WAGNER
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    State                |    SD
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    Zip                  |    57380-9675
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    Country              |    US
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    Telephone            |    605-384-3611
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    Fax                  |    605-384-3232
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     BRITTANY  BARRON 
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    Credential           |    RN,BSN
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    Telephone            |    605-384-3611
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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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