Provider Demographics
NPI:1174715213
Name:DAKOTA VALLEY SCHOOL DISTRICT 61-8
Entity type:Organization
Organization Name:DAKOTA VALLEY SCHOOL DISTRICT 61-8
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL SERVICE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-422-3800
Mailing Address - Street 1:1150 NORTHSHORE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH SIOUX CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57049-4080
Mailing Address - Country:US
Mailing Address - Phone:605-422-3800
Mailing Address - Fax:
Practice Address - Street 1:1150 NORTHSHORE DR
Practice Address - Street 2:
Practice Address - City:NORTH SIOUX CITY
Practice Address - State:SD
Practice Address - Zip Code:57049-4080
Practice Address - Country:US
Practice Address - Phone:605-422-3800
Practice Address - Fax:605-422-3807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5153000Medicaid