| NPI | 1578342259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOINETTE GOODEN Clinical Director 605-646-3045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| 171000000X Military Health Care Provider | |
| 172A00000X Driver | |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2023-10-20 |