| NPI | 1689225351 |
|---|---|
| Other Name | RED LAKE URBAN AVIVO SERVICES |
| Entity Type | Organization |
| Authorized Contact | ALISHA MARIE GEHLERT Economic Dev. Director 218-679-1461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |