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LEECH LAKE BAND OF OJIBWE NPI 1215341094


NPI Information

NPI: 1215341094
Provider Name: LEECH LAKE BAND OF OJIBWE

Doing Business As: LEECH LAKE ADOLESCENT OUTPATIENT SERVICES

Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
321 2ND ST
CASS LAKE, MN
ZIP 56633
Phone: (218) 335-8382
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LEECH LAKE BAND OF OJIBWE is an adolescent and children mental health clinic center in Cass Lake, MN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. LEECH LAKE BAND OF OJIBWE NPI is 1215341094. The provider is registered as an organization entity type.
The provider Is Doing Business As Leech Lake Adolescent Outpatient Services.

The provider's business location address is:

321 2ND ST
CASS LAKE, MN
ZIP 56633
Phone: (218) 335-8382
Fax: (218) 335-3580

The provider's authorized official is Earl Robinson .
The authorized official title is Human Services Director and has the following contact phone number (218) 335-8295.

The enumeration date for this NPI number is 6/19/2014 and was last updated on 1/31/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)No
2261QM0855XClinic/CenterAdolescent and Children Mental HealthYes

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: 4/28/2024

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