Provider Demographics
NPI:1922400522
Name:LATANDA SALMEN, LLC
Entity Type:Organization
Organization Name:LATANDA SALMEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMEN
Authorized Official - Suffix:
Authorized Official - Credentials:CSWPIP
Authorized Official - Phone:605-549-5448
Mailing Address - Street 1:111 W 39TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-5732
Mailing Address - Country:US
Mailing Address - Phone:605-549-5448
Mailing Address - Fax:605-221-0310
Practice Address - Street 1:111 W 39TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-5732
Practice Address - Country:US
Practice Address - Phone:605-549-5448
Practice Address - Fax:605-221-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD31531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty