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RED LAKE CHEMICAL HEALTH PROGRAMS NPI 1578070991


NPI Information

NPI: 1578070991
Provider Name: RED LAKE CHEMICAL HEALTH PROGRAMS

Former Legal Business Name: OOSKI-KII-MII-KAH HALFWAY HOUSE

Classification: Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy - 332800000X
Entity Type: Organization
Address:
15566 DAKOTA AVENUE
REDBY, MN
ZIP 56670
Phone: (218) 679-3387
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RED LAKE CHEMICAL HEALTH PROGRAMS is an indian health service tribal urban indian health i t u pharmacy in Redby, MN. The provider is an Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. RED LAKE CHEMICAL HEALTH PROGRAMS NPI is 1578070991. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Ooski-kii-mii-kah Halfway House.

The provider's business location address is:

15566 DAKOTA AVENUE
REDBY, MN
ZIP 56670
Phone: (218) 679-3387
Fax: (218) 679-2375

The provider's authorized official is Reyna Cruz Gonzalez-rivera .
The authorized official title is Project Director and has the following contact phone number (218) 679-3392.

The enumeration date for this NPI number is 1/8/2018 and was last updated on 3/20/2019.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityNo
2332800000XIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1649755100MEDICAIDMINNESOTA

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.