Provider Demographics
NPI:1962122010
Name:BLACKFEET TRIBE
Entity type:Organization
Organization Name:BLACKFEET TRIBE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEASEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:406-338-2686
Mailing Address - Street 1:PO BOX 728
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417-0728
Mailing Address - Country:US
Mailing Address - Phone:406-338-2686
Mailing Address - Fax:406-338-7779
Practice Address - Street 1:728 S GOVERNMENT SQ
Practice Address - Street 2:
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417-5272
Practice Address - Country:US
Practice Address - Phone:406-338-2686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care