| Eggleston, Inc | |
|
1601 E 69th St Ste 101 Sioux Falls SD 57108-8322 | |
| (605) 610-6355 | |
| Not Available |
| Full Name | Eggleston, Inc |
|---|---|
| Speciality | Counselor |
| Location | 1601 E 69th St Ste 101, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Mary J Eggleston (PRESIDENT) |
| Authorized Official Contact | 6056106355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eggleston, Inc 1601 E 69th St Ste 101 Sioux Falls SD 57108-8322 Ph: (605) 610-6355 | Eggleston, Inc 1601 E 69th St Ste 101 Sioux Falls SD 57108-8322 Ph: (605) 610-6355 |
| NPI Number | 1891918033 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 07/03/2023 |
| Certification Date | 07/03/2023 |
| Medicare PECOS PAC ID | 6204278963 |
|---|---|
| Medicare Enrollment ID | O20240525000422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891918033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LPC537 (South Dakota) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Mary J Eggleston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437142288 PECOS PAC ID: 7012359771 Enrollment ID: I20240525000426 |
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