| Fch School Based Health Services/hawthorne | |
|
601 N Spring Ave Sioux Falls SD 57104-2721 | |
| (605) 367-8793 | |
| Not Available |
| Full Name | Fch School Based Health Services/hawthorne |
|---|---|
| Speciality | Clinic/Center |
| Location | 601 N Spring Ave, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Jill Franken (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6053678761 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fch School Based Health Services/hawthorne 521 N Main Ave Suite 100 Sioux Falls SD 57104-5948 Ph: (605) 367-8793 | Fch School Based Health Services/hawthorne 601 N Spring Ave Sioux Falls SD 57104-2721 Ph: (605) 367-8793 |
| NPI Number | 1609025907 |
|---|---|
| Provider Enumeration Date | 09/11/2008 |
| Last Update Date | 01/11/2013 |
| Medicare PECOS PAC ID | 7810943859 |
|---|---|
| Medicare Enrollment ID | O20081104000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609025907 | NPI | - | NPPES |
| 431843 | Other | MEDICARE FQHC | |
| 5350310 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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