Organization
STATE TREATMENT AND REHABILITATION ACADEMY
Active
Parent organization
SOUTH DAKOTA DEPARTMENT OF CORRECTIONS
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH DAKOTA DEPARTMENT OF CORRECTIONS
Authorized official
CHARLES GILSON (DIRECTOR)
(605) 673-2521
Entity
Organization
Contact information
Practice address
25298 BADGER CLARK RD, CUSTER, SD 57730-8244
(605) 673-4835
Mailing address
12279 BRADY DR, CUSTER, SD 57730-9160
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5160280
—
SD
Enumeration date
08/14/2007
Last updated
08/14/2007
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