Organization
NORTHWEST INDIAN COMMUNITY DEVELOPMENT CENTER
Active
Other names
Northwest Indian Community Development Center aka Northwest Indian OIC, Northwest Indian Community Development Center
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA G CONN (DIRECTOR OF OPERATIONS AND FINANCE)
(218) 759-2022
Entity
Organization
Contact information
Practice address
1819 BEMIDJI AVE N STE 1, BEMIDJI, MN 56601
(218) 759-2022
(218) 759-0090
Mailing address
1819 BEMIDJI AVE N STE 1, BEMIDJI, MN 56601-3874
(218) 759-2022
(218) 759-0090
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163WH0200X
—
MN
05
—
172V00000X
—
MN
05
—
3747P1801X
—
MN
05
—
374U00000X
—
MN
Enumeration date
01/06/2016
Last updated
03/10/2022
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