| NPI | 1770712721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE LATIMER Health Services Administrator 605-668-1138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2009-07-13 |