Organization
CHILDREN'S THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUSTIN RAE CASEY LPTA (OWNER)
(605) 877-2550
Entity
Organization
Contact information
Practice address
1774 CENTRE ST, SUITE #1, RAPID CITY, SD 57703-4029
(605) 716-2634
Mailing address
1774 CENTRE ST, SUITE #1, RAPID CITY, SD 57703-4029
(605) 716-2634
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
0628
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5834854
—
SD
Enumeration date
06/14/2014
Last updated
06/14/2014
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