| Organization Name: | ROSEBUD SIOUX TRIBE ALCOHOL DRUG TREATMENT PROGRAM |
| NPI Number: | 1063602365 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARCIDA BEATRICE EAGLE BEAR (EXECUTIVE DIRECTOR) |
| Mailing Address: | #7 Hospital Lane Rosebud |
| State: | SD US |
| Postal Code: | 57570 |
| Phone Number: | 6057472342 |
| Fax Number: | 6057472111 |
| NPI Enumeration Date: | 08/01/2007 |
| NPI Last Update Date: | 08/01/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 347C00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Private Vehicle |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |