Provider Demographics
NPI:1972210862
Name:FLANDREAU SANTEE SIOUX TRIBE
Entity Type:Organization
Organization Name:FLANDREAU SANTEE SIOUX TRIBE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:KASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-573-2100
Mailing Address - Street 1:909 S JONES DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLANDREAU
Mailing Address - State:SD
Mailing Address - Zip Code:57028
Mailing Address - Country:US
Mailing Address - Phone:605-573-2100
Mailing Address - Fax:
Practice Address - Street 1:909 JONES DR
Practice Address - Street 2:
Practice Address - City:FLANDREAU
Practice Address - State:SD
Practice Address - Zip Code:57028
Practice Address - Country:US
Practice Address - Phone:605-573-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLANDREAU SANTEE SIOUX TRIBE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility