Provider Demographics
NPI:1851856009
Name:YANKTON SIOUX TRIBE
Entity Type:Organization
Organization Name:YANKTON SIOUX TRIBE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRIBAL CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYING HAWK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-469-5370
Mailing Address - Street 1:P.O. BOX 1153
Mailing Address - Street 2:
Mailing Address - City:WAGNER
Mailing Address - State:SD
Mailing Address - Zip Code:57380-9602
Mailing Address - Country:US
Mailing Address - Phone:605-384-3641
Mailing Address - Fax:605-384-5687
Practice Address - Street 1:800 MAIN SW
Practice Address - Street 2:
Practice Address - City:WAGNER
Practice Address - State:SD
Practice Address - Zip Code:57380-9602
Practice Address - Country:US
Practice Address - Phone:605-384-3641
Practice Address - Fax:605-384-5687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty