Provider Demographics
NPI:1710110671
Name:SANTEE SIOUX NATION
Entity Type:Organization
Organization Name:SANTEE SIOUX NATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-857-2300
Mailing Address - Street 1:110 S VISITING EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:NIOBRARA
Mailing Address - State:NE
Mailing Address - Zip Code:68760-7201
Mailing Address - Country:US
Mailing Address - Phone:402-857-2300
Mailing Address - Fax:402-857-2315
Practice Address - Street 1:110 S VISITING EAGLE ST
Practice Address - Street 2:
Practice Address - City:NIOBRARA
Practice Address - State:NE
Practice Address - Zip Code:68760-7201
Practice Address - Country:US
Practice Address - Phone:402-857-2300
Practice Address - Fax:402-857-2315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14453416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport