Provider Demographics
NPI:1417600321
Name:DAKOTA MASSAGE LLC
Entity Type:Organization
Organization Name:DAKOTA MASSAGE LLC
Other - Org Name:DAKOTA MASSAGE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIIBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-655-4477
Mailing Address - Street 1:100 DOUGLAS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-4474
Mailing Address - Country:US
Mailing Address - Phone:605-655-4477
Mailing Address - Fax:
Practice Address - Street 1:100 DOUGLAS AVE STE 102
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-4474
Practice Address - Country:US
Practice Address - Phone:605-655-4477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization