BOWLING GREEN INN OF SOUTH DAKOTA (NPI# 1306398011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306398011 |
| Entity Type | Organization |
| Organization Name | BOWLING GREEN INN OF SOUTH DAKOTA |
| Other Organization Name | KEYSTONE TREATENT CENTER |
| Practice Address |
3800 S Kiwanis Ave Sioux Falls SD 57105-4234 |
| Practice Telephone | 6053351820 |
| Practice Fax Number | 6053351820 |
| Mailing Telephone | 6053351820 |
| Mailing Fax Number | 6053351820 |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2016-10-28 |
| Authorized Official Name | MRS. CAROL A. REGIER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6059872751 |
| Authorized Official Credential | RN, LAC |
| Is Organization Subpart | Y |
| Parent Organization Name | BOWLING GREEN INN OF SOUTH DAKOTA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 10504 | SD | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Keystone Treatent Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104885649 | Bowling Green Inn of South Dakota | Substance Abuse Rehabilitation Facility | 1010 E 2nd St, Canton, SD 57013-1905 | 2006-03-22 |
| 1154677896 | Bowling Green Inn of South Dakota | Substance Abuse Rehabilitation Facility | 1010 E 2nd St, Canton, SD 57013-1905 | 2012-07-31 |
| Street Address |
3800 S KIWANIS AVE |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-4234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154979805 | Avera Mckennan | Substance Abuse Rehabilitation Facility | 6140 S Curae Lane, Sioux Falls, SD 57108-3047 | 2019-08-27 |
| 1518206051 | Volunteers of America,dakotas | Substance Abuse Rehabilitation Facility | 1310 W 51st St, Sioux Falls, SD 57105-6606 | 2013-02-04 |
| 1902937394 | The Glory House of Sioux Falls | Substance Abuse Rehabilitation Facility | 4000 S West Ave, Sioux Falls, SD 57105-6601 | 2007-03-08 |
| 1952446411 | Carroll Institute | Substance Abuse Rehabilitation Facility | 310 S 1st Ave, Sioux Falls, SD 57104-6329 | 2007-02-21 |
| 1164786240 | Volunteers of America,dakotas | Substance Abuse Rehabilitation Facility | 1401 W 51st St, Sioux Falls, SD 57105-6657 | 2012-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295090082 | Wellspring, Inc. | Substance Abuse Rehabilitation Facility | 1205 E Saint James St, Rapid City, SD 57701-3958 | 2012-07-09 |
| 1902057631 | Anpetu Luta Otipi | Substance Abuse Rehabilitation Facility | Bia Hwy 39 No Flesh Road, Box 275, Kyle, SD 57752-0275 | 2008-09-30 |
| 1629235627 | Black Hills Recovery Center | Substance Abuse Rehabilitation Facility | 1807 Williams St, Sturgis, SD 57785-1142 | 2008-05-19 |
| 1225208010 | Rosebud Sioux Tribe Alcohol Drug Treatment Program | Substance Abuse Rehabilitation Facility | # 7 Hospital Lane, Rosebud, SD 57570-0348 | 2008-03-07 |
| 1316167505 | Rosebud Sioux Tribe Piya Mani Otipi | Substance Abuse Rehabilitation Facility | Bristal Ranch Hwy 18, Mission, SD 57555-0428 | 2007-04-27 |
| 1194851469 | Pennington County Sheriff's Office | Substance Abuse Rehabilitation Facility | 725 N Lacrosse St, Ste 300, Rapid City, SD 57701-1491 | 2007-02-23 |
| 1508900507 | Dakotah Pride Center Sisseton Wahpeton Oyate | Substance Abuse Rehabilitation Facility | 388 Dakota Ave, Sisseton, SD 57262-3327 | 2007-02-16 |
| 1659411171 | Ysi Springfield Academy | Substance Abuse Rehabilitation Facility | 709 6th St, Springfield, SD 57062 | 2007-02-07 |
| 1275615783 | Hot Springs Veterans Administration | Substance Abuse Rehabilitation Facility | 500 North Fifth St, Va Hot Springs, Hot Springs, SD 57747 | 2006-10-20 |
| 1548219108 | Timberline Treatment Center | Substance Abuse Rehabilitation Facility | 2910 4th Ave, Spearfish, SD 57783-3224 | 2006-05-09 |
| Find all providers with the same taxonomy | ||||
| City | SIOUX FALLS |
| Zip Code | 57105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.