Organization
ABBOTT HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY MOORE (BUSINESS MGR)
(605) 996-2486
Entity
Organization
Contact information
Practice address
909 COURT MERRILL ST, MITCHELL, SD 57301-4362
(605) 996-2486
(605) 996-4585
Mailing address
909 COURT MERRILL ST, MITCHELL, SD 57301-4362
(605) 996-2486
(605) 996-4585
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5000400
—
SD
05
—
5160000
—
SD
05
—
5169080
—
SD
Enumeration date
05/14/2007
Last updated
04/21/2011
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