Organization
HORSEPLAY PRODUCTIONS HEALING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARI LYNN BRADSTREAM MS, EAGALA CERTIFIED (CHIEF EXECUTIVE OFFICER)
(605) 343-1620
Entity
Organization
Contact information
Practice address
1101 E. PHILADELPHIA STREET, RAPID CITY, SD 57701
(805) 343-1620
(605) 343-1629
Mailing address
PO BOX 276, RAPID CITY, SD 57709-0276
(805) 343-1620
(605) 343-1629
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
102274
SD
101YM0800X
Mental Health Counselor
Primary
LPC1102
SD
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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