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MEDICINE WHEEL VILLAGE NPI 1699159236


NPI Information

NPI: 1699159236
Provider Name: MEDICINE WHEEL VILLAGE
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 43D2060529

Address:
24266 AIRPORT RD
EAGLE BUTTE, SD
ZIP 57625
Phone: (605) 964-8155
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MEDICINE WHEEL VILLAGE is an assisted living facility in Eagle Butte, SD. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. MEDICINE WHEEL VILLAGE NPI is 1699159236. The provider is registered as an organization entity type.

The provider's business location address is:

24266 AIRPORT RD
EAGLE BUTTE, SD
ZIP 57625
Phone: (605) 964-8155
Fax: (605) 964-8158

The provider's authorized official is Kimberly D Clown .
The authorized official title is Assisted Living Administrator and has the following contact phone number (605) 964-8155.

The CLIA number assigned to this NPI record is 43D2060529 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/14/2015 and was last updated on 7/14/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility65643SOUTH DAKOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.