Provider Demographics
NPI:1861121196
Name:RECOURSE SOLUTIONS SIOUX EMPIRE LLC
Entity type:Organization
Organization Name:RECOURSE SOLUTIONS SIOUX EMPIRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:COURNOYER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MH, QMHP
Authorized Official - Phone:605-271-6979
Mailing Address - Street 1:24791 PINE CIR
Mailing Address - Street 2:
Mailing Address - City:DELL RAPIDS
Mailing Address - State:SD
Mailing Address - Zip Code:57022-5332
Mailing Address - Country:US
Mailing Address - Phone:605-759-6978
Mailing Address - Fax:
Practice Address - Street 1:629 S MINNESOTA AVE STE 203
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4876
Practice Address - Country:US
Practice Address - Phone:605-271-6979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1235129446Medicaid