Provider Demographics
NPI:1033306543
Name:SIOUX VALLEY SCHOOL DISTRICT 5 5
Entity Type:Organization
Organization Name:SIOUX VALLEY SCHOOL DISTRICT 5 5
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARDITH
Authorized Official - Middle Name:C
Authorized Official - Last Name:VAN BEEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-627-5657
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:VOLGA
Mailing Address - State:SD
Mailing Address - Zip Code:57071-0278
Mailing Address - Country:US
Mailing Address - Phone:605-627-5657
Mailing Address - Fax:605-627-5291
Practice Address - Street 1:200 HANSINA AVE
Practice Address - Street 2:
Practice Address - City:VOLGA
Practice Address - State:SD
Practice Address - Zip Code:57071-0278
Practice Address - Country:US
Practice Address - Phone:605-627-5657
Practice Address - Fax:605-627-5291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5150430Medicaid