Organization
GREAT PLAINS AREA YOUTH REGIONAL TREATMENT CENTER
Active
Other names
IHS Great Plains Area Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
LAVON BOOTH (PROGRAM DIRECTOR)
(605) 845-7181
Entity
Organization
Contact information
Practice address
12451 HWY 1806 N, MOBRIDGE, SD 57601-5760
(605) 845-7181
(605) 845-5072
Mailing address
PO BOX 680, MOBRIDGE, SD 57601-0680
(605) 850-8249
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2022304
—
SD
05
—
5095050
—
SD
Enumeration date
05/12/2022
Last updated
08/04/2022
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