Organization Active NPI

Human Service Agency

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Watertown, SD
National Provider Identifier
1043115280
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
HUMAN SERVICE AGENCY
Practice address
123 19TH St NE
Watertown, SD 57201-2823
Phone
(605) 886-0123
Fax
(605) 886-5447
NPI assigned
Oct 8, 2026
Last updated
Oct 12, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
HUMAN SERVICE AGENCYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kendra Wildberger
Title
Account Specialist
Phone
(605) 886-5447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

123 19TH St NE
Watertown, SD 57201-2823

Mailing address

123 19TH St NE
Watertown, SD 57201-2823
Phone (605) 886-0123

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1791417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791763200000",
    "number": "1043115280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 19TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572012823",
            "telephone_number": "605-886-0123",
            "fax_number": "605-886-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 19TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572012823",
            "telephone_number": "605-886-0123",
            "fax_number": "605-886-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SERVICE AGENCY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HUMAN SERVICE AGENCY",
        "enumeration_date": "2026-10-08",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A",
        "authorized_official_last_name": "WILDBERGER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "ACCOUNT SPECIALIST",
        "authorized_official_telephone_number": "605-886-5447"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.