NPIMap

Organization Active NPI

Southeastern Behavioral Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
National Provider Identifier
1114002573
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SOUTHEASTERN BEHAVIORAL HEALTHCARE
Practice address
2000 S Summit Ave
Sioux Falls, SD 57105
Phone
(605) 336-0510
NPI assigned
Oct 26, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Robyn Brower
Title
Business Manager
Phone
(605) 336-0510

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X SD

Addresses

Primary practice location

2000 S Summit Ave
Sioux Falls, SD 57105

Mailing address

2000 S Summit Ave
Sioux Falls, SD 57105-2727
Phone (605) 336-0510

Other identifiers 2

IdentifierTypeStateIssuer
5200020MedicaidSD
1002113OtherSDBLUE CROSS & BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000821 SD Part B Supplier - Clinic/Group Practice 7618867367 Receives reassigned benefits from 23 practitioners
Practice locations: Sioux Falls, SD

National Provider Directory

National Provider Directory

Locations

100 W 5th St
Sioux Falls, SD 57104
Phone (605) 271-2338

Practitioners & affiliated clinicians

Practitioners 108

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 108

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1114002573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S SUMMIT AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052727",
            "telephone_number": "605-336-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S SUMMIT AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57105",
            "telephone_number": "605-336-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN BEHAVIORAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "BROWER",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "605-336-0510"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "SD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5200020",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "1002113",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.