Provider Demographics
NPI:1174785992
Name:SD REHABILITATION CENTER FOR THE BLIND
Entity type:Organization
Organization Name:SD REHABILITATION CENTER FOR THE BLIND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:BACKER
Authorized Official - Suffix:
Authorized Official - Credentials:CLVT
Authorized Official - Phone:605-367-5260
Mailing Address - Street 1:2900 W 11TH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104
Mailing Address - Country:US
Mailing Address - Phone:605-367-5260
Mailing Address - Fax:
Practice Address - Street 1:2900 W 11TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104
Practice Address - Country:US
Practice Address - Phone:605-367-5260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SD DEPARTMENT OF HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management