Provider Demographics
NPI:1669512414
Name:SIOUX FALLS PUBLIC SCHOOL
Entity type:Organization
Organization Name:SIOUX FALLS PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CHW PROGRAM
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:KAE
Authorized Official - Last Name:LANDEEN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, CHES, CPH
Authorized Official - Phone:605-367-4463
Mailing Address - Street 1:2320 N CAREER AVE
Mailing Address - Street 2:SULLIVAN HEALTH BLDG., 208
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57107-1301
Mailing Address - Country:US
Mailing Address - Phone:605-222-6562
Mailing Address - Fax:
Practice Address - Street 1:201 E 38TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-5815
Practice Address - Country:US
Practice Address - Phone:605-367-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5150680Medicaid