Provider Demographics
NPI:1487430518
Name:BLACK HILLS AUDIOLOGY LLC
Entity type:Organization
Organization Name:BLACK HILLS AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST, FOUNDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:SABERS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:406-600-2458
Mailing Address - Street 1:3718 HALL ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2228
Mailing Address - Country:US
Mailing Address - Phone:406-600-2458
Mailing Address - Fax:
Practice Address - Street 1:803 SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2609
Practice Address - Country:US
Practice Address - Phone:406-600-2458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty