Organization
OUR HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE GUBBRUD (EXECUTIVE DIRECTOR)
(605) 352-4368
Entity
Organization
Contact information
Practice address
334 3RD ST SW, HURON, SD 57350-2418
(605) 352-4368
(605) 352-4976
Mailing address
334 3RD ST SW, HURON, SD 57350-2418
(605) 352-4368
(605) 352-4976
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
R130
SD
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
R97
SD
3245S0500X
Children's Substance Abuse Rehabilitation Facility
408
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5000090
—
SD
05
—
5160132
—
SD
05
—
5160140
—
SD
Enumeration date
02/08/2007
Last updated
08/24/2015
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