| Aayrtc | |
|
12451 Highway 1806 Mobridge SD 57601-0680 | |
| (605) 845-7181 | |
| (605) 845-5072 |
| Full Name | Aayrtc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12451 Highway 1806, Mobridge, South Dakota |
| Authorized Official Name and Position | Delaine Keller (MEDICAL SUPPORT ASSISTANT) |
| Authorized Official Contact | 6058457181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aayrtc Po Box 680 12451 Highway 1806 Mobridge SD 57601-0680 Ph: (605) 845-7181 | Aayrtc 12451 Highway 1806 Mobridge SD 57601-0680 Ph: (605) 845-7181 |
| NPI Number | 1518039627 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 12/29/2022 |
| Certification Date | 12/29/2022 |
| Medicare PECOS PAC ID | 9436534880 |
|---|---|
| Medicare Enrollment ID | O20220921000774 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518039627 | NPI | - | NPPES |
| 5095050 | Medicaid | SD | |
| 807 | Other | SD | DHS ACCREDITATION |
| 76292 | Other | CARF ACCREDITATION |
| Provider Name | Karen S Severns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750604120 PECOS PAC ID: 7012216062 Enrollment ID: I20180307000199 |
| Provider Name | Colleen L Campbell-lane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750523395 PECOS PAC ID: 7618006743 Enrollment ID: I20220921001068 |
| Provider Name | Robyn L Black Feather |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225592371 PECOS PAC ID: 4284010810 Enrollment ID: I20221004003526 |
| Provider Name | Christine D Manns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932516705 PECOS PAC ID: 3173993748 Enrollment ID: I20221227000219 |
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