Organization
ANISHINAABE ENDAAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM FAIRBANKS (PRINCIPAL)
(612) 208-6613
Entity
Organization
Contact information
Practice address
424 2ND ST NW, MAHNOMEN, MN 56557-4316
(612) 208-6613
Mailing address
3529 ZENITH AVE N, ROBBINSDALE, MN 55422-2347
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
08/14/2021
Last updated
08/14/2021
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