# TREC BADLANDS PRENATAL TO FIVE HEAD START

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295039220
- **Authorized official:** MR. DOUGLAS JACOBSON MSW,MBA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (605) 723-8837

## Contact information

- **Practice address:** 101 5TH AVE, BELLE FOURCHE, SD 57717-1139
- **Practice address phone:** (605) 723-8837
- **Practice address fax:** (605) 723-8834
- **Mailing address:** 101 5TH AVE, BELLE FOURCHE, SD 57717-1139
- **Mailing address phone:** (605) 723-8837
- **Mailing address fax:** (605) 723-8834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | — | SD | Yes |

## Other

- **Enumeration date:** 01/05/2011
- **Last updated:** 07/21/2022