Provider Demographics
NPI:1962414870
Name:GROVE, GALEN ALDEAN (CCDC-IIIR)
Entity type:Individual
Prefix:MR
First Name:GALEN
Middle Name:ALDEAN
Last Name:GROVE
Suffix:
Gender:M
Credentials:CCDC-IIIR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 10TH ST SW
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-3061
Mailing Address - Country:US
Mailing Address - Phone:605-352-7405
Mailing Address - Fax:
Practice Address - Street 1:357 KANSAS AVE SE
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-2517
Practice Address - Country:US
Practice Address - Phone:605-352-8596
Practice Address - Fax:605-352-7001
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)