Organization Name: | NORTHERN CHEYENNE TRIBE |
NPI Number: | 1568716090 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RACHEL E LARANCE (3RD PARTY BILLING CLERK) |
Mailing Address: | 112 East Eaglefeathers Street Lame Deer |
State: | MT US |
Postal Code: | 590430067 |
Phone Number: | 4064776722 |
Fax Number: | 4064776829 |
NPI Enumeration Date: | 11/06/2012 |
NPI Last Update Date: | 08/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |