Provider Demographics
NPI:1174722169
Name:CHILDREN'S CARE HOSPITAL AND SCHOOL
Entity type:Organization
Organization Name:CHILDREN'S CARE HOSPITAL AND SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-444-9500
Mailing Address - Street 1:2501 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2446
Mailing Address - Country:US
Mailing Address - Phone:605-444-9500
Mailing Address - Fax:605-444-9601
Practice Address - Street 1:7110 JORDAN DRIVE
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-8738
Practice Address - Country:US
Practice Address - Phone:605-791-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10562261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5400110Medicaid
8CH02OtherBCBS
9173610OtherDAKOTACARE
21135OtherSANFORD
NE=========32MedicaidPT
=========02OtherTRICARE
21135OtherSANFORD
SD5400110Medicaid
=========0055OtherCIGNA