Provider Demographics
NPI:1326210014
Name:CHEYENNE RIVER HEALTH CARE CORPORATION
Entity Type:Organization
Organization Name:CHEYENNE RIVER HEALTH CARE CORPORATION
Other - Org Name:MEDICINE WHEEL VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGEMENT CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BACHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NHA, RHIT, BSBA
Authorized Official - Phone:605-200-9521
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:EAGLE BUTTE
Mailing Address - State:SD
Mailing Address - Zip Code:57625-0160
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:EAGLE BUTTE
Practice Address - State:SD
Practice Address - Zip Code:57625-0000
Practice Address - Country:US
Practice Address - Phone:605-200-9521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility