Provider Demographics
NPI:1275318966
Name:YELLOW BRICK ROAD MENTAL HEALTH
Entity Type:Organization
Organization Name:YELLOW BRICK ROAD MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-271-1419
Mailing Address - Street 1:805 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-5031
Mailing Address - Country:US
Mailing Address - Phone:715-271-1419
Mailing Address - Fax:605-271-5542
Practice Address - Street 1:3508 S MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6457
Practice Address - Country:US
Practice Address - Phone:605-214-6855
Practice Address - Fax:605-271-5542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty