| Organization Name: | ROSEBUD SIOUX TRIBE -CHR |
| NPI Number: | 1073867420 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLEE I ARCHAMBAULT (HEALTH ADMNINISTRATOR) |
| Mailing Address: | 100 Dialysis Lane Rosebud |
| State: | SD US |
| Postal Code: | 575700719 |
| Phone Number: | 6057475100 |
| Fax Number: | 6057475412 |
| NPI Enumeration Date: | 11/07/2012 |
| NPI Last Update Date: | 11/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 347C00000X |
| License Number: | 67 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| 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. |