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110 State St Plankinton SD 57368-5736 | |
(605) 682-9258 | |
(605) 734-8113 |
Full Name | |
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Speciality | Counselor - Mental Health |
Location | 110 State St, Plankinton, South Dakota |
Authorized Official Name and Position | Jonathan J Busch (OWNER) |
Authorized Official Contact | 6059906500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 65 Plankinton SD 57368-0065 Ph: (605) 682-9258 | 110 State St Plankinton SD 57368-5736 Ph: (605) 682-9258 |
NPI Number | 1124515218 |
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Provider Enumeration Date | 04/16/2018 |
Last Update Date | 02/05/2025 |
Identifier | Type | State | Issuer |
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1124515218 | NPI | - | NPPES |
2013822 | Medicaid | SD |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | 2422 (South Dakota) | Primary |