Provider Demographics
NPI:1629574017
Name:TINY KNIGHT SAFETY AND ASSURANCE INC
Entity Type:Organization
Organization Name:TINY KNIGHT SAFETY AND ASSURANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TY
Authorized Official - Middle Name:AARON JOSEPH
Authorized Official - Last Name:DILLABOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-216-9777
Mailing Address - Street 1:260224 RANGE ROAD 35
Mailing Address - Street 2:
Mailing Address - City:COCHRANE
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T4C0B7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:202 S MAIN ST STE 530
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4114
Practice Address - Country:US
Practice Address - Phone:605-216-9777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QS1000X
SD333300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health