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15797 Main Ave Hwy 1 Redlake MN 56671-0114 | |
(218) 679-3392 | |
(218) 679-3976 |
Full Name | |
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Speciality | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy |
Location | 15797 Main Ave, Redlake, Minnesota |
Authorized Official Name and Position | Salena L Branchaud (PROGRAM MANGER) |
Authorized Official Contact | 2186793392 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 114 Redlake MN 56671-0114 Ph: (218) 679-3392 | 15797 Main Ave Hwy 1 Redlake MN 56671-0114 Ph: (218) 679-3392 |
NPI Number | 1881802411 |
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Provider Enumeration Date | 05/18/2007 |
Last Update Date | 03/27/2019 |
Identifier | Type | State | Issuer |
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1881802411 | NPI | - | NPPES |
627635100 | Medicaid | MN |
Red Lake Comprehensive Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 24760 Hospital Drive, Redlake, MN 56671 Phone: 218-679-3316 Fax: 218-679-3990 |