Provider Demographics
NPI:1952375164
Name:REGIONAL HEALTH NETWORK INC
Entity Type:Organization
Organization Name:REGIONAL HEALTH NETWORK INC
Other - Org Name:HOSPICE OF THE NORTHERN HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO-RHN
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-716-8375
Mailing Address - Street 1:PO BOX 3450
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57709-3450
Mailing Address - Country:US
Mailing Address - Phone:605-644-4000
Mailing Address - Fax:
Practice Address - Street 1:1440 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1505
Practice Address - Country:US
Practice Address - Phone:605-644-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL HEALTH NETWORK INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-14
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10566251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0154190Medicaid
SD431513Medicare Oscar/Certification