Provider Demographics
NPI:1790857860
Name:CATHOLIC FAMILY SERVICES
Entity Type:Organization
Organization Name:CATHOLIC FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-988-3775
Mailing Address - Street 1:523 N DULUTH AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-2714
Mailing Address - Country:US
Mailing Address - Phone:605-988-3775
Mailing Address - Fax:605-988-3747
Practice Address - Street 1:309 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-3621
Practice Address - Country:US
Practice Address - Phone:605-988-3775
Practice Address - Fax:605-988-3747
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC FAMILY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-14
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC MH 2087101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD20202OtherSIOUX VALLEY HEALTH PLAN
SD6575620Medicaid
SD46045OtherAVERA HEALTH PLAN
SD9173854OtherDAKOTA CARE
SD11350OtherMIDLANDS CHOICE
SD4997066OtherBLUE CROSS BLUE SHIELD