| Psychiatric Services, Llc | |
|
306 4th St Suite G Brookings SD 57006-1948 | |
| (605) 697-5352 | |
| (605) 610-1561 |
| Full Name | Psychiatric Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 306 4th St, Brookings, South Dakota |
| Authorized Official Name and Position | Brenda L Johnson (OWNER) |
| Authorized Official Contact | 6056975352 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Services, Llc 306 4th St Suite G Brookings SD 57006-1948 Ph: (605) 697-5352 | Psychiatric Services, Llc 306 4th St Suite G Brookings SD 57006-1948 Ph: (605) 697-5352 |
| NPI Number | 1497016562 |
|---|---|
| Provider Enumeration Date | 06/05/2012 |
| Last Update Date | 06/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497016562 | NPI | - | NPPES |
| 20110813516668 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | CP000650 (South Dakota) | Primary |
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