NPIMap

Organization Active NPI

Rosebud Sioux Tribe Alcohol Drug Treatment Program

  • Private Vehicle
  • Rosebud, SD
National Provider Identifier
1063602365
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Private VehicleTaxonomy code 347C00000X
Legal business name
ROSEBUD SIOUX TRIBE ALCOHOL DRUG TREATMENT PROGRAM
Practice address
#7 Hospital Lane
Rosebud, SD 57570
Phone
(605) 747-2342
Fax
(605) 747-2111
NPI assigned
Aug 1, 2007
Last updated
Aug 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Marcida Beatrice Eagle Bear, M.A., CCDCIII
Title
Executive Director
Phone
(605) 747-2342

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X NU Primary

Addresses

Primary practice location

#7 Hospital Lane
Rosebud, SD 57570

Mailing address

PO Box 348, #7 Hospital Lane
Rosebud, SD 57570
Phone (605) 747-2342

Other identifiers 1

IdentifierTypeStateIssuer
9515310MedicaidSD

National Provider Directory

National Provider Directory
Tax ID family
Rosebud Sioux Tribe -CHR8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1063602365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 348, #7 HOSPITAL LANE",
            "city": "ROSEBUD",
            "state": "SD",
            "postal_code": "57570",
            "telephone_number": "605-747-2342",
            "fax_number": "605-747-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#7 HOSPITAL LANE",
            "city": "ROSEBUD",
            "state": "SD",
            "postal_code": "57570",
            "telephone_number": "605-747-2342",
            "fax_number": "605-747-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEBUD SIOUX TRIBE ALCOHOL DRUG TREATMENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "EAGLE BEAR",
        "authorized_official_first_name": "MARCIDA",
        "authorized_official_middle_name": "BEATRICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "605-747-2342",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A., CCDCIII"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9515310",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosebud, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.