Organization
LIFE LIGHT COUNSELING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIM M REID CCDCII (EXECUTIVE DIRECTOR)
(605) 996-2070
Entity
Organization
Contact information
Practice address
1315 N MAIN ST, SUITE 100, MITCHELL, SD 57301-1359
(605) 996-2070
(605) 996-2395
Mailing address
1315 N MAIN ST, SUITE 100, MITCHELL, SD 57301-1359
(605) 996-2070
(605) 996-2395
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5000270
—
SD
Enumeration date
11/16/2006
Last updated
08/22/2020
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