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Organization
RED LAKE CHEMICAL HEALTH PROGRAMS
Active
Organization
RED LAKE CHEMICAL HEALTH PROGRAMS
Active
Other names
Red Lake Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
REYNA CRUZ GONZALEZ-RIVERA (PROJECT DIRECTOR)
(218) 679-3392
Entity
Organization
Contact information
Practice address
14414 GREEN LAKE ROAD, REDBY, MN 56670
(218) 679-3868
(218) 679-3398
Mailing address
P.O. BOX 114, RED LAKE, MN 56671
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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