RED LAKE BAND OF CHIPPEWA INDIANS (NPI# 1689225351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689225351 |
| Entity Type | Organization |
| Organization Name | RED LAKE BAND OF CHIPPEWA INDIANS |
| Practice Address |
1900 Chicago Ave Minneapolis MN 55404-1903 |
| Mailing Address |
Po Box 587 Redlake MN 56671-0587 |
| Practice Telephone | 2186791455 |
| Practice Fax Number | 6513834937 |
| Mailing Telephone | 2186791455 |
| Mailing Fax Number | 6513834937 |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |
| Authorized Official Name | ALISHA MARIE GEHLERT (ECONOMIC DEV. DIRECTOR) |
| Authorized Official Telephone | 2186791461 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| Red Lake Urban Avivo Services | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972139814 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 34966 605th Ave, Warroad, MN 56763-9022 | 2020-03-22 |
| 1184250029 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 10200 Highway 89, Redlake, MN 56671-2500 | 2020-03-22 |
| 1437785375 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 20595 Center St E, Thief River Falls, MN 56701-8016 | 2020-03-22 |
| 1124214887 | Red Lake Band of Chippewa Indians | Community/Behavioral Health | 15816 Agency Street, Redlake, MN 56671-0472 | 2007-09-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | RED LAKE BAND OF CHIPPEWA INDIANS | 24200 Council St, Redlake, MN 56671 |
| Street Address |
1900 CHICAGO AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55404-1903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629122924 | Resource, Inc. | Case Management | 1900 Chicago Ave, Minneapolis, MN 55404-1903 | 2007-01-23 |
| 1598387367 | Dara Mari Dickey | Social Worker | 1900 Chicago Ave, Minneapolis, MN 55404-1903 | 2020-05-14 |
| 1619511102 | Alicia Pauline Johnson | Counselor | 1900 Chicago Ave, Minneapolis, MN 55404-1903 | 2019-10-29 |
| 1659923175 | Kerry Rose Toole | Counselor | 1900 Chicago Ave, Minneapolis, MN 55404-1903 | 2019-07-15 |
| 1063881472 | Stephanie Kiess | Rehabilitation Practitioner | 1900 Chicago Ave, Minneapolis, MN 55404-1903 | 2015-09-16 |
| 1427195825 | Resource, Inc. | Case Management | 1900 Chicago Ave, Minneapolis, MN 55404-1903 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1760969125 | Bethany Karen Kenny | Registered Nurse | 910 E 26th St Ste 200, Minneapolis, MN 55404 | 2018-07-27 |
| 1225535701 | Karissa Dougherty | Nurse Practitioner | 2200 E Franklin Ave # 199, Minneapolis, MN 55404 | 2018-04-10 |
| 1891299491 | Guidance Home Health Care LLC | Home Health | 2529 Nicollet Avenue 202b, Minneapolis, MN 55404 | 2018-03-20 |
| 1770085490 | Bright Future Counseling Service, LLC | Counselor | 912 E. 24th St., Suite B215, Minneapolis, MN 55404 | 2018-03-08 |
| 1346754298 | Juba Pharmacy Inc | Pharmacy | 1926 Chicago Ave S, Minneapolis, MN 55404 | 2017-11-29 |
| 1629597323 | Kira Larson Fieldstrom | Social Worker | 2400 Blaisdell Ave., Minneapolis, MN 55404 | 2017-09-13 |
| 1770008930 | Nicole Lynn Sparks | Social Worker | 2445 Park Avenue, Minneapolis, MN 55404 | 2017-08-09 |
| 1639612765 | Cosmo Home Healthcare Services, L.L.C. | Home Health | 2219 Oakland Ave S, Suite 104, Minneapolis, MN 55404 | 2016-11-21 |
| Find all providers in zip 55404 | ||||
| Taxonomy Code | 332800000X |
| Grouping | Suppliers |
| Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| 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. |
| Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164920963 | Nacc Tribal Health Services | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2018-01-26 |
| 1386152833 | Nacc Medication Assisted Recovery Services | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2018-01-18 |
| 1700064714 | Fond Du Lac Reservation Business Committee | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 2020 Bloomington Ave, Minneapolis, MN 55404-3073 | 2008-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972139814 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 34966 605th Ave, Warroad, MN 56763-9022 | 2020-03-22 |
| 1184250029 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 10200 Highway 89, Redlake, MN 56671-2500 | 2020-03-22 |
| 1437785375 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 20595 Center St E, Thief River Falls, MN 56701-8016 | 2020-03-22 |
| 1376026153 | Children's Healing Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 25060 Hwy 1 East, Red Lake, MN 56671 | 2018-09-08 |
| 1730696154 | Red Lake Chemical Health Programs | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 14414 Green Lake Road, Redby, MN 56670 | 2018-01-08 |
| 1144765843 | Bois Forte Reservation Tribal Government | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1224 White Pine Cir, Tower, MN 55790 | 2017-01-04 |
| 1629256763 | Fond Du Lac Reservation Business Committee | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 221 W 4th St, Duluth, MN 55806-2719 | 2008-01-31 |
| 1700394640 | Red Lake Chemical Health Programs | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 15797 Main Ave, Red Lake, MN 56671-0114 | 2018-01-12 |
| City | MINNEAPOLIS |
| Zip Code | 55404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.