Provider Demographics
NPI:1508581067
Name:INTER-LAKES COMMUNITY ACTION PARTNERSHIP
Entity Type:Organization
Organization Name:INTER-LAKES COMMUNITY ACTION PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-256-6518
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:SD
Mailing Address - Zip Code:57042-0268
Mailing Address - Country:US
Mailing Address - Phone:605-265-6518
Mailing Address - Fax:605-256-2238
Practice Address - Street 1:111 N VAN EPS AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:SD
Practice Address - Zip Code:57042-2800
Practice Address - Country:US
Practice Address - Phone:605-256-6518
Practice Address - Fax:605-256-2238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty