Organization
FLANDREAU SANTEE SIOUX TRIBE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID W WALFORD (BILLER/ CREDENTIALING)
(650) 573-5166
Entity
Organization
Contact information
Practice address
403 W BROAD AVE, FLANDREAU, SD 57028
(605) 997-2642
(605) 997-2225
Mailing address
PO BOX 329, FLANDREAU, SD 57028-0329
(605) 997-2642
(605) 997-2225
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5546010
—
SD
Enumeration date
07/01/2006
Last updated
10/26/2022
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