Healthcare Provider Details

I. General information

NPI: 1821446253
Provider Name (Legal Business Name): OGLALA SIOUX LAKOTA NURSING HOME, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7835 STATE HIGHWAY 87
RUSHVILLE NE
69360-0001
US

IV. Provider business mailing address

DRIVE 7835 STATE HIGHWAY 87
RUSHVILLE NE
69360-0000
US

V. Phone/Fax

Practice location:
  • Phone: 605-899-0823
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: SUSAN POURIER
Title or Position: ADMINISTRATOR
Credential:
Phone: 605-899-0823