Organization
B S BEHIND BARS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY HENDRICKS (EXECUTIVE DIRECTOR)
(605) 753-9395
Entity
Organization
Contact information
Practice address
9 W KEMP AVE, WATERTOWN, SD 57201-3539
(605) 753-5990
Mailing address
9 W KEMP AVE, WATERTOWN, SD 57201-3539
(605) 753-5990
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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