Sisseton Wahpeton Oyate
Organization Active NPI Clinic/Center · Agency Village, SD
NPI 1346734696 · NPPES record last updated Jan 4, 2024
Key facts
- NPI
- 1346734696
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- SISSETON WAHPETON OYATE
- Practice address
- 12554 Bia Hwy 711
Agency Village, SD 57262 - Phone
- (605) 698-3911
- Fax
- (605) 698-3276
- NPI assigned
- Jun 20, 2018
- Organization subpart
- No
Authorized official
- Name
- Mr. Edmund Johnson Jr.
- Title
- Sisseton-Wahpeton Oyate Tribal Secr
- Phone
- (605) 698-3911
Corporate family (same tax ID) 6
National Provider Directory
- Tax ID family
- Dakotah Pride Center Sisseton Wahpeton Oyate
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker |
172V00000X | |||
| Local Education Agency (LEA) | 251300000X | |||
| Early Intervention Provider Agency | 252Y00000X | |||
| Foster Care Agency | 253J00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Clinic/Center | 261Q00000X | Yes | ||
| Home Delivered Meals | 332U00000X | |||
| Private Vehicle | 347C00000X |
Addresses
Primary practice location
12554 Bia Hwy 711
Agency Village, SD 57262
Mailing address
PO Box 509
Agency Village, SD 57262
Phone (605) 698-3911
Other providers in Agency Village, SD
- Sisseton Wahpeton Oyate of the Lake Traverse Reservation
- Sisseton Wahpeton Oyate of the Lake Traverse Reservation
- Tiospa Zina Tribal School
All providers in Agency Village, SD · Clinic/Center in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.