Organization
ROSEBUD SIOUX TRIBE ALCOHOL DRUG TREATMENT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARCIDA BEATRICE EAGLE BEAR M.A., CCDCIII (EXECUTIVE DIRECTOR)
(605) 747-2342
Entity
Organization
Contact information
Practice address
#7 HOSPITAL LANE, ROSEBUD, SD 57570
(605) 747-2342
(605) 747-2111
Mailing address
PO BOX 348, #7 HOSPITAL LANE, ROSEBUD, SD 57570
(605) 747-2342
(605) 747-2111
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9515310
—
SD
Enumeration date
08/01/2007
Last updated
08/01/2007
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