| Leech Lake Behavioral Health | |
|
16123 Grant Utley Ave Nw Cass Lake MN 56633 | |
| (218) 335-3050 | |
| (218) 335-4410 |
| Full Name | Leech Lake Behavioral Health |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 16123 Grant Utley Ave Nw, Cass Lake, Minnesota |
| Authorized Official Name and Position | Earl Robinson (LEECH LAKE HUMAN SERVICES DIRECTOR) |
| Authorized Official Contact | 2183358295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leech Lake Behavioral Health 115 6th Street Nw, Ste. E Cass Lake MN 56633 Ph: (218) 335-3050 | Leech Lake Behavioral Health 16123 Grant Utley Ave Nw Cass Lake MN 56633 Ph: (218) 335-3050 |
| NPI Number | 1275823742 |
|---|---|
| Provider Enumeration Date | 04/18/2011 |
| Last Update Date | 02/28/2020 |
| Certification Date | 02/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275823742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 19439 (Minnesota) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Minnesota) | Primary |
Leech Lake Outpatient Treatment Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6095 161st Ave Nw, Cass Lake, MN 56633 Phone: 218-335-8308 Fax: 218-335-8307 | |
Leech Lake Band Of Ojibwe Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 6th Street Nw, Cass Lake, MN 56633 Phone: 218-335-8273 Fax: 218-335-8352 | |
Leech Lake Women's Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 Balsom Ave Nw, Cass Lake, MN 56633 Phone: 218-335-3560 Fax: 218-335-2482 |