Provider Demographics
NPI:1073695334
Name:ENEMY SWIM DAY SCHOOL
Entity Type:Organization
Organization Name:ENEMY SWIM DAY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:605-947-4605
Mailing Address - Street 1:13525 446TH AVE
Mailing Address - Street 2:
Mailing Address - City:WAUBAY
Mailing Address - State:SD
Mailing Address - Zip Code:57273-5715
Mailing Address - Country:US
Mailing Address - Phone:606-947-4605
Mailing Address - Fax:605-947-4188
Practice Address - Street 1:13525 446TH AVE
Practice Address - Street 2:
Practice Address - City:WAUBAY
Practice Address - State:SD
Practice Address - Zip Code:57273-5715
Practice Address - Country:US
Practice Address - Phone:606-947-4605
Practice Address - Fax:605-947-4188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty