SIOUX FALLS, S.D. (KELO) — Sanford Health has announced its expansion into the Black Hills area, where they will become the parent company of Black Hills Surgical Hospital and Black Hills Orthopedic and Spine Center, along with the pair’s additional facilities and services in Rapid City and the Black Hills Surgery Center in Gillette, Wyoming.

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Wyoming will become the 22nd state with a Sanford presence, joining with others across the nation which host a Sanford Health service, Sanford Senior Care service or a Sanford World Clinic presence.

Sanford currently operates health services in Montana, and senior care services in Idaho, Colorado, Arizona, New Mexico, Kansas, Texas, Arkansas, Wisconsin, Indiana, Tennessee, Hawaii and Florida. Sanford operates both types in Oregon, North Dakota, South Dakota, Nebraska, Iowa and Minnesota.

In addition to this, Sanford has Sanford World Clinic presence in both California and Oklahoma. Overall, Sanford World Clinics have a presence in the United States, Guatemala, Costa Rica, Ireland, Germany, Ghana, South Africa, Vietnam and New Zealand.

In total, the current footprint breaks down to 45 medical centers, 211 clinics, and 168 senior living centers.