Rapid City Club for Boys, Inc.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

RAPID CITY CLUB FOR BOYS, INC.

Practice address

320 N. 4TH St.
Rapid City, SD 57701

Phone

(605) 343-3500

Fax

(605) 343-3501

NPI assigned

Mar 13, 2023

Organization subpart

No

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

Authorized official

Name

Douglas Herrmann

Title

Executive Director

Phone

(605) 343-3500

Specialties & licenses 1

Addresses

Other names 1

• Club For Boys Doing business as

Locations

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1154022697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N. 4TH ST.",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-343-3500",
            "fax_number": "605-343-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N. 4TH ST.",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-343-3500",
            "fax_number": "605-343-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAPID CITY CLUB FOR BOYS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "HERRMANN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "605-343-3500"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Club For Boys",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Health Worker in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Community Health Worker in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.