Organization
SUN HEALTH
Active
Other names
Lara Reinecke
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LARA E. REINECKE LCSW-PIP (CLINICAL SOCIAL WORKER)
(208) 484-9792
Entity
Organization
Contact information
Practice address
2509 WINDMILL DR APT 507, SPEARFISH, SD 57783-9589
(208) 484-9792
(307) 643-2139
Mailing address
2509 WINDMILL DR APT 507, SPEARFISH, SD 57783-9589
(208) 484-9792
(307) 643-2139
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2354
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S102766
MEDICARE PTAN
SD
Enumeration date
02/02/2009
Last updated
02/02/2009
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