Provider Demographics
NPI:1437280294
Name:NATIVE AMERICAN ADVOCACY PROGRAM
Entity Type:Organization
Organization Name:NATIVE AMERICAN ADVOCACY PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BULL BEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:605-842-3977
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:WINNER
Mailing Address - State:SD
Mailing Address - Zip Code:57580-0527
Mailing Address - Country:US
Mailing Address - Phone:605-842-3977
Mailing Address - Fax:605-842-3983
Practice Address - Street 1:302 EAST 2ND STREET
Practice Address - Street 2:
Practice Address - City:WINNER
Practice Address - State:SD
Practice Address - Zip Code:57580-1831
Practice Address - Country:US
Practice Address - Phone:605-842-3977
Practice Address - Fax:605-842-3983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSDCL 34-20A-27174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty