Organization
SOUTH DAKOTA DEVELOPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEAGAN RAE BRULEY PHARMD (DIRECTOR OF PHARMACY)
(605) 472-4231
Entity
Organization
Contact information
Practice address
17267 W 3RD ST, REDFIELD, SD 57469-1001
(605) 472-4231
(605) 472-4439
Mailing address
17267 W 3RD ST, REDFIELD, SD 57469-1001
(605) 472-2400
(605) 472-4457
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0169020
—
SD
Enumeration date
03/08/2007
Last updated
07/25/2023
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