|
| |
|
528 Quincy St Rapid City SD 57701-3628 | |
| (605) 348-5401 | |
| (605) 348-7319 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 528 Quincy St, Rapid City, South Dakota |
| Authorized Official Name and Position | Richard Pierce Renka (PRESIDENT) |
| Authorized Official Contact | 6053485401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
528 Quincy St P O Box 288 Rapid City SD 57701-3628 Ph: (605) 348-5401 | 528 Quincy St Rapid City SD 57701-3628 Ph: (605) 348-5401 |
| NPI Number | 1770660714 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 11/08/2007 |
| Medicare PECOS PAC ID | 4082695648 |
|---|---|
| Medicare Enrollment ID | O20040528000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770660714 | NPI | - | NPPES |
| 7100070 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 0133 (South Dakota) | Primary |
| Provider Name | Richard P Renka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801882287 PECOS PAC ID: 8224222906 Enrollment ID: I20101027000861 |
Childrens Home Society Of South Dakota Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5301 Us-16 West, Rapid City, SD 57701 Phone: 605-393-4278 Fax: 605-341-7437 | |
Isaacs Behavioral Health, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2650 Jackson Blvd, Rapid City, SD 57702 Phone: 605-877-2010 | |
Youth & Family Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 E Adams St, Rapid City, SD 57701 Phone: 605-342-4789 | |
Mark W. Perrenoud Ph.d. Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1818 West Fulton, Suite 201, Rapid City, SD 57702 Phone: 605-348-6500 Fax: 605-341-7409 | |
Cornell Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 900 Concourse Dr Ste E-227, Rapid City, SD 57703 Phone: 605-549-5433 Fax: 605-309-7919 |