| Red Lake Medication Assisted Recovery Services | |
|
24760 Hospital Drive Red Lake MN 56671 | |
| (218) 679-3995 | |
| (218) 679-3976 |
| Full Name | Red Lake Medication Assisted Recovery Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 24760 Hospital Drive, Red Lake, Minnesota |
| Authorized Official Name and Position | Salena Leigh Beasley (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2186791543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Red Lake Medication Assisted Recovery Services P.o. Box 114 Red Lake MN 56671 Ph: (218) 679-3996 | Red Lake Medication Assisted Recovery Services 24760 Hospital Drive Red Lake MN 56671 Ph: (218) 679-3995 |
| NPI Number | 1902325426 |
|---|---|
| Provider Enumeration Date | 09/15/2017 |
| Last Update Date | 09/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902325426 | NPI | - | NPPES |
| 1002 | Other | MN | TRIBAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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