Provider Demographics
NPI:1699820316
Name:EAST CENTRAL MENTAL HEALTH & CHEMICAL DEPENDENCY CENTER
Entity Type:Organization
Organization Name:EAST CENTRAL MENTAL HEALTH & CHEMICAL DEPENDENCY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-697-2850
Mailing Address - Street 1:211 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-1917
Mailing Address - Country:US
Mailing Address - Phone:605-697-2850
Mailing Address - Fax:605-697-2874
Practice Address - Street 1:211 4TH ST
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-1917
Practice Address - Country:US
Practice Address - Phone:605-697-2850
Practice Address - Fax:605-697-2874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS2415Medicare ID - Type UnspecifiedMEDICARE