Provider Demographics
NPI:1124889381
Name:DAKOTA BEHAVIORAL HEALTH PLLC
Entity type:Organization
Organization Name:DAKOTA BEHAVIORAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:ROWE
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:605-702-6769
Mailing Address - Street 1:PO BOX 168
Mailing Address - Street 2:
Mailing Address - City:WINNER
Mailing Address - State:SD
Mailing Address - Zip Code:57580-0168
Mailing Address - Country:US
Mailing Address - Phone:605-702-6769
Mailing Address - Fax:605-340-1115
Practice Address - Street 1:1309 E WELLS AVE
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-3964
Practice Address - Country:US
Practice Address - Phone:605-702-6769
Practice Address - Fax:605-340-1115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty