Provider Demographics
NPI:1841030434
Name:ADULT DAY CENTER OF THE BLACK HILLS
Entity type:Organization
Organization Name:ADULT DAY CENTER OF THE BLACK HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARCLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-791-0436
Mailing Address - Street 1:4110 WINFIELD CT
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-8306
Mailing Address - Country:US
Mailing Address - Phone:605-269-0337
Mailing Address - Fax:
Practice Address - Street 1:4110 WINFIELD CT
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-8306
Practice Address - Country:US
Practice Address - Phone:605-269-0337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty