Provider Demographics
NPI:1164786240
Name:VOLUNTEERS OF AMERICA,DAKOTAS
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA,DAKOTAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE & TECHNOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:COLLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON-BLISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-444-6318
Mailing Address - Street 1:1309 W 51ST ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6659
Mailing Address - Country:US
Mailing Address - Phone:605-339-1199
Mailing Address - Fax:605-335-5514
Practice Address - Street 1:1401 W 51ST ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6657
Practice Address - Country:US
Practice Address - Phone:605-334-1414
Practice Address - Fax:605-335-3121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-03
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10522324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5169540Medicaid