MILLE LACS BAND OF OJIBWE INDIANS (NPI# 1831385509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831385509 |
Entity Type | Organization |
Organization Name | MILLE LACS BAND OF OJIBWE INDIANS |
Other Organization Name | AAZHOOMOG CLINIC |
Practice Address |
45741 Grace Lake Road Sandstone MN 55072-3203 |
Mailing Address |
18562 Minobimaadizi Loop Onamia MN 56359 |
Practice Telephone | 3203840149 |
Practice Fax Number | 3203840916 |
Mailing Telephone | 3205324163 |
Mailing Fax Number | 3205327495 |
Enumeration Date | 2007-09-17 |
Last Update Date | 2020-08-10 |
Authorized Official Name | NICOLE ANDERSON (COMMISSIONER OF HEALTH & HUMAN SERV) |
Authorized Official Telephone | 3205324163 |
Is Organization Subpart | Y |
Parent Organization Name | MILLE LACS BAND OF OJIBWE INDIANS |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Aazhoomog Clinic | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104053669 | Mille Lacs Band of Ojibwe Indians | Community/Behavioral Health | 502 Weber Avenue, Suite 201, Hinckley, MN 55037-6410 | 2009-06-11 |
1548496060 | Mille Lacs Band of Ojibwe Indians | Substance Abuse Rehabilitation Facility | 17222 Ataage Dr, Onamia, MN 56359 | 2009-06-10 |
1831388909 | Mille Lacs Band of Ojibwe Indians | Community/Behavioral Health | 42293 Twilight Rd, Onamia, MN 56359 | 2007-10-15 |
1982729364 | Mille Lacs Band of Ojibwe Indians | Pharmacy | 43500 Migizi Drive, Onamia, MN 56359 | 2007-03-21 |
1104996867 | Mille Lacs Band of Ojibwe Indians | Clinic/Center | 18562 Minobimaadizi Loop, Onamia, MN 56359-2241 | 2006-11-09 |
1699390518 | Mille Lacs Band of Ojibwe Indians | Community/Behavioral Health | 18562 Minobimaadizi Loop, Onamia, MN 56359 | 2020-06-16 |
1831624857 | Mille Lacs Band of Ojibwe Indians | Clinic/Center | 43500 Migizi Dr, Onamia, MN 56359 | 2017-04-27 |
1285186007 | Mille Lacs Band of Ojibwe Indians | Substance Abuse Rehabilitation Facility | 11600 State Ave, Brainerd, MN 56401 | 2016-10-27 |
1407223035 | Mille Lacs Band of Ojibwe Indians | Home Delivered Meals | 18562 Minobimaadizi Loop, Onamia, MN 56359-3001 | 2015-08-31 |
1164659652 | Mille Lacs Band of Ojibwe Indians | Community/Behavioral Health | 36666 State Highway 65, Mcgregor, MN 55760 | 2009-06-11 |
Street Address |
45741 GRACE LAKE ROAD |
City | SANDSTONE |
State | MN |
Zip Code | 55072-3203 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972034189 | Kc Companies of Sandstone Inc/sandstone Golden Horizons | Assisted Living Facility | 1109 Lundorff, Sandstone, MN 55072 | 2017-03-21 |
1124414032 | Sherri Lynn Anderson | Licensed Practical Nurse | 29916 Anderson Dr., Sandstone, MN 55072 | 2015-04-08 |
1346676541 | Sheila Ann Carr | Custodial Care Facility | 27295 Groningen Road, Sandstone, MN 55072 | 2013-09-19 |
1043497662 | Lori J Dougherty | Technician | 119 Fouth St., Sandstone, MN 55072 | 2008-01-25 |
1215114830 | Cindy Kuhlman | Technician | 119 Fourth St., Sandstone, FM 55072 | 2008-01-25 |
1699951590 | Reta Joyce Diedrich | Registered Nurse | 119 4th St., Sandstone, MN 55072 | 2008-01-10 |
1134303381 | Deedree Ann Ludwig | Community Health Worker | 119 4th. St., Sandstone, MN 55072 | 2007-12-24 |
1043494297 | Minnie Mae Delaney | Community Health Worker | 119 4th Street, Sandstone, MN 55072 | 2007-12-24 |
1710068838 | Chris A Ketchmark | Chiropractor | 301 N Commercial Ave, Sandstone, MN 55072 | 2006-10-17 |
1326041633 | Pine Medical Center | General Acute Care Hospital | 705 Lundorff Drive South, Sandstone, MN 55072 | 2005-05-31 |
Find all providers in zip 55072 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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1760949168 | Indian Health Board of Minneapolis, Inc | Clinic/Center | 2101 Minnehaha Avenue South, Minneapolis, MN 55404-3107 | 2019-02-22 |
1891266862 | Hennepin County | Clinic/Center | 41 N 12th St., Minneapolis, MN 55403-1325 | 2018-12-17 |
1700357779 | Hennepin County | Clinic/Center | 2211 Clinton Ave, Minneapolis, MN 55404-3656 | 2018-12-17 |
1487125597 | Hennepin County | Clinic/Center | 215 S 8th St, Minneapolis, MN 55402-2803 | 2018-12-16 |
1992276000 | Hennepin County | Clinic/Center | 2740 1st Ave S, Minneapolis, MN 55408-1611 | 2018-12-16 |
Find all providers with the same taxonomy |
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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.