Provider First Line Business Practice Location Address:
4500 EAST HWY 18 / PINE RIDGE HOSPITAL
Provider Second Line Business Practice Location Address:
BEHAVIORAL HEALTH DEPT./ INDIAN HEALTH SERVICE
Provider Business Practice Location Address City Name:
PINE RIDGE
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57770-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-867-3100
Provider Business Practice Location Address Fax Number:
605-867-3274
Provider Enumeration Date:
03/11/2007