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RED LAKE MEDICATION ASSISTED RECOVERY SERVICES NPI 1902325426


NPI Information

NPI: 1902325426
Provider Name: RED LAKE MEDICATION ASSISTED RECOVERY SERVICES
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
24760 HOSPITAL DRIVE
RED LAKE, MN
ZIP 56671
Phone: (218) 679-3995
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RED LAKE MEDICATION ASSISTED RECOVERY SERVICES is a community behavioral health in Red Lake, MN. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. RED LAKE MEDICATION ASSISTED RECOVERY SERVICES NPI is 1902325426. The provider is registered as an organization entity type.

The provider's business location address is:

24760 HOSPITAL DRIVE
RED LAKE, MN
ZIP 56671
Phone: (218) 679-3995
Fax: (218) 679-3976

The provider's authorized official is Salena Leigh Beasley .
The authorized official title is Executive Director and has the following contact phone number (218) 679-1543.

The enumeration date for this NPI number is 9/15/2017 and was last updated on 9/15/2017.


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
1251S00000XCommunity/Behavioral HealthYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11002OTHERMINNESOTATRIBAL LICENSE

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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