1669512414 NPI number — SIOUX FALLS PUBLIC SCHOOL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669512414 NPI number — SIOUX FALLS PUBLIC SCHOOL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SIOUX FALLS PUBLIC SCHOOL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669512414
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2320 N CAREER AVE
Provider Second Line Business Mailing Address:
SULLIVAN HEALTH BLDG., 208
Provider Business Mailing Address City Name:
SIOUX FALLS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57107-1301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-222-6562
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 E 38TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57105-5815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-367-7900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LANDEEN
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
KAE
Authorized Official Title or Position:
DIRECTOR, CHW PROGRAM
Authorized Official Telephone Number:
605-367-4463

Provider Taxonomy Codes

  • Taxonomy code: 172V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5150680 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".




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