| NPI | 1780990457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSANNE A LEMMER Administrator 605-472-2191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: SD 40127) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2010-08-19 |