STATE TREATMENT AND REHABILITATION ACADEMY – NPI #1205028131
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.

STATE TREATMENT AND REHABILITATION ACADEMY is a substance abuse rehabilitation facility located in CUSTER, SD. NPPES has assigned the NPI number 1205028131 to STATE TREATMENT AND REHABILITATION ACADEMY on August 14, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 3245S0500X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility, specializing in Substance Abuse Treatment, Children

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for STATE TREATMENT AND REHABILITATION ACADEMY below.

NPI Profile for
STATE TREATMENT AND REHABILITATION ACADEMY

NPI Number
1205028131
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
STATE TREATMENT AND REHABILITATION ACADEMY
Primary location
25298 BADGER CLARK RD
CUSTER, SD 57730-8244
Phone: (605) 673-4835 Fax:
Mailing address
12279 BRADY DR
CUSTER, SD 57730-9160
Phone: Fax:
Organization Subpart
Yes - STATE TREATMENT AND REHABILITATION ACADEMY is subpart of another organization.
Authorized Official
CHARLES GILSON
DIRECTOR
Phone: (605) 673-2521
Updated
Identifiers

Identifiers for STATE TREATMENT AND REHABILITATION ACADEMY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDSD5160280
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3245S0500X
- Substance Abuse Rehabilitation Facility / Substance Abuse Treatment, Children (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.