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NPI Code Detail

MEDICARE: MR. ERIC RAY ABELS CAC

MEDICARE: MR. ERIC RAY ABELS CAC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor15101708SD

General Provider Information

NPI Number : 1922740521
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ERIC RAY ABELS CAC
Provider Business Mailing Address
First Line : 2519 W 8TH ST # 2519W
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-5606
Country : US
Telephone Number : 605-332-3236
Fax Number : 605-334-5026
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 : 605-332-3236
Fax Number : 605-334-5026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2022
Last Update Date : 04/13/2022

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