NPIMap

Organization Active NPI

Lutheran Social Services of SD

Doing business as Summit Oaks Center I

  • Psychiatric Residential Treatment Facility
  • Sioux Falls, SD
National Provider Identifier
1366628414
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
R49 Issued in SD
Legal business name
LUTHERAN SOCIAL SERVICES OF SD
Doing business as
Summit Oaks Center I
Practice address
621 E Presentation St
Sioux Falls, SD 57104-0820
Phone
(605) 221-2346
Fax
(605) 221-2404
NPI assigned
Jan 18, 2008
Last updated
Jun 18, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
LUTHERAN SOCIAL SERVICES OF SDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Steve Anderson
Title
Vice President, Support Services
Phone
(605) 357-0108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X R49 SD Primary

Addresses

Primary practice location

621 E Presentation St
Sioux Falls, SD 57104-0820

Mailing address

705 E 41St St Ste 200
Sioux Falls, SD 57105-6048
Phone (605) 357-0112

Other identifiers 2

IdentifierTypeStateIssuer
5169060MedicaidSD
55514MedicaidND

Other names 1

  • Summit Oaks Center I Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366628414. Details of each certification follow.

  • CCN 43L006 Psychiatric residential treatment facility · Active · Name & address match · Details

Psychiatric residential treatment facility certification: CCN 43L006

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SUMMIT OAKS CENTER
Certification status
Active
Provider type (POS)
Psychiatric residential treatment facility
Participating since
Oct 1, 2007
Last certification
Aug 10, 2023
Beds
34
Ownership / control type
Non-profit – other
Facility address
621 Presentation Street
Sioux Falls, SD 57104

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Social Services of South Dakota Inc5 organizations share this tax ID, including this one
Part of
Lutheran Social Services of South Dakota Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

621 E Presentation St
Sioux Falls, SD 57104
Phone (605) 221-2346

705 E 41st St
Ste 200
Sioux Falls, SD 57105
Phone (605) 357-0100

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1366628414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E 41ST ST STE 200",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056048",
            "telephone_number": "605-357-0112",
            "fax_number": "605-357-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E PRESENTATION ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571040820",
            "telephone_number": "605-221-2346",
            "fax_number": "605-221-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF SD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUTHERAN SOCIAL SERVICES OF SD",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "VICE PRESIDENT, SUPPORT SERVICES",
        "authorized_official_telephone_number": "605-357-0108"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "SD",
            "license": "R49",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5169060",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55514",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Oaks Center I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.