Leech Lake Reservation in Cass Lake - Federally Qualified Health Center (fqhc)
Leech Lake Reservation - NPI 1639368863
Leech Lake Reservation is a Federally Qualified Health Center (fqhc) in Cass Lake, Minnesota. Leech Lake Reservation practices all healthcare services and medical treatments related to Federally Qualified Health Center (fqhc). The NPI Number for Leech Lake Reservation is 1639368863. The last update date is 2007-10-24.
Leech Lake Reservation's current location address is 115 6th St Ne, Cass Lake, Minnesota. You can contact this provider via phone number 2183354500 and fax number 2183354513. The mailing address for Leech Lake Reservation is 115 6th St Ne, Cass Lake, Minnesota. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Leech Lake Reservation |
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Address | 115 6th St Ne, Cass Lake, Minnesota |
Phone Number | 2183354500 |
Fax Number | 2183354513 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | INTERIM HE |
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Authorized Official Name | Bebeau Joel |
Telephone Number | 2183354500 |
NPI Number Detail
NPI Number | 1639368863 |
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Provider Enumeration Date | 2007-10-24 |
Last Updated Date | 2007-10-24 |
Provider Mailing Address Detail
Address | 115 6th St Ne |
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City | Cass Lake |
State | Minnesota (MN) |
Post Code | 566333428 |
Phone Number | 2183354500 |
Fax Number | 2183354513 |
Provider's Primary Taxonomy Detail
Speciality | Federally Qualified Health Center (fqhc) |
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Taxonomy | 261Qf0400X |
Definition: Provides primary and preventive care services in underserved areas, receiving certain federal funding grants. |
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What is the unique identifier code issued to Leech Lake Reservation by the Centers for Medicare & Medicaid Services?
The Leech Lake Reservation has been assigned the NPI (National Provider Identifier) 1639368863. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Leech Lake Reservation is physically located?
The Leech Lake Reservation is physically situated at the following address: 115 6Th St Ne, Cass Lake, MN, 566333428.
What is Leech Lake Reservation's specialized field of practice, and what is the corresponding taxonomy classification code?
The Leech Lake Reservation's area of specialization is Federally Qualified Health Center (fqhc), and the corresponding taxonomy code that categorizes this field of practice is 261Qf0400X.
When was the Leech Lake Reservation's 1639368863 issued?
The Leech Lake Reservation's 1639368863 was issued on 2007-10-24.
As of what date were the details pertaining to Leech Lake Reservation last refreshed?
The information related to the Leech Lake Reservation, including its address, specialty, and other relevant details, was last updated on 2007-10-24.