| Leech Lake Outpatient Treatment Program | |
|
6095 161st Ave Nw Cass Lake MN 56633-3428 | |
| (218) 335-8308 | |
| (218) 335-8307 |
| Full Name | Leech Lake Outpatient Treatment Program |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 6095 161st Ave Nw, Cass Lake, Minnesota |
| Authorized Official Name and Position | Gloria Mellado (A & D PROGRAM DIRECTOR) |
| Authorized Official Contact | 2183353567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leech Lake Outpatient Treatment Program 6905 161st St. Nw Cass Lake MN 56633-3428 Ph: (218) 335-8308 | Leech Lake Outpatient Treatment Program 6095 161st Ave Nw Cass Lake MN 56633-3428 Ph: (218) 335-8308 |
| NPI Number | 1275701666 |
|---|---|
| Provider Enumeration Date | 02/19/2008 |
| Last Update Date | 07/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275701666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
Leech Lake Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16123 Grant Utley Ave Nw, Cass Lake, MN 56633 Phone: 218-335-3050 Fax: 218-335-4410 | |
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 |