Organization
RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA
Active
Other names
Red Cliff Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA ANN DERAGON-NAVARRO (HEALTH ADMINISTRATOR)
(715) 779-3707
Entity
Organization
Contact information
Practice address
88455 PIKE ROAD, BAYFIELD, WI 54814
(715) 779-3707
(715) 779-3711
Mailing address
88385 PIKE RD, BAYFIELD, WI 54814-4818
(715) 779-3700
(715) 779-3704
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
772-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42200000
MEDICAID-MENTAL HEALTH
WI
Enumeration date
03/12/2008
Last updated
03/12/2008
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