Organization
WELLSPRING WHOLISTIC CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA KOTZEA (SECRETARY/TREASURER)
(605) 925-7002
Entity
Organization
Contact information
Practice address
804 S WALNUT ST, FREEMAN, SD 57029
(605) 925-7002
Mailing address
PO BOX 73, FREEMAN, SD 57029
(605) 925-7002
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007699
BC/BS GROUP NUMBER
SD
Enumeration date
05/05/2006
Last updated
11/18/2014
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