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NPI Code Detail

MEDICARE: SIOUX FALLS TREATMENT CENTER, LLC

MEDICARE: SIOUX FALLS TREATMENT CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
3261QM2800XMethadone Clinic

General Provider Information

NPI Number : 1861788143
Entity Type Code : Organization
Provider Name (Legal Business Name) : SIOUX FALLS TREATMENT CENTER, LLC
Provider Business Mailing Address
First Line : 2519 W 8TH ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-5606
Country : US
Telephone Number : 605-332-3552
Fax Number : 605-332-3236
Provider Business Practice Location Address
First Line : 2519 W 8TH ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-5606
Country : US
Telephone Number : 605-332-3552
Fax Number : 605-332-3236
Authorized Official
Title or Position : VP, TREASURER
Name : BRUCE JARVIE
Credential :
Telephone Number : 214-379-3300
Provider Enumeration Date : 06/24/2011
Last Update Date : 07/29/2024

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