| NPI | 1881802411 |
|---|---|
| Other Name | RED LAKE OUTPATIENT PROGRAM |
| Entity Type | Organization |
| Authorized Contact | SALENA L BRANCHAUD Program Manger 218-679-3392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2019-03-27 |