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Organization
RED LAKE NATION YOUTH SAFE HARBOR INC
Active
Organization
RED LAKE NATION YOUTH SAFE HARBOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLENE ANDERSEN (REVENUE GENERATION MANAGER)
(218) 679-1320
Entity
Organization
Contact information
Practice address
15834 PILL HILL AVENUE, RED LAKE, MN 56671-0590
(218) 679-6071
Mailing address
PO BOX 590, REDLAKE, MN 56671-0590
(218) 679-6071
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/02/2022
Last updated
07/17/2023
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