| White Earth Mat Program | |
|
26246 Crane Rd White Earth MN 56591-9998 | |
| (218) 983-3285 | |
| (218) 983-4343 |
| Full Name | White Earth Mat Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 26246 Crane Rd, White Earth, Minnesota |
| Authorized Official Name and Position | Jeri Jasken (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Contact | 2189834647 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| White Earth Mat Program 26246 Crane Rd White Earth MN 56591-9998 Ph: (218) 983-3285 | White Earth Mat Program 26246 Crane Rd White Earth MN 56591-9998 Ph: (218) 983-3285 |
| NPI Number | 1073972048 |
|---|---|
| Provider Enumeration Date | 02/18/2016 |
| Last Update Date | 02/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073972048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
White Earth Education Division Children's Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 35233 Mission Lake Road, White Earth, MN 56591 Phone: 218-983-4180 Fax: 218-983-3767 | |
White Earth Tribal Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 35686 County Hwy 21, White Earth, MN 56591 Phone: 218-983-3285 Fax: 218-983-4236 |