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Organization

LEECH LAKE BAND OF OJIBWE

Active
Other names
Leech Lake Behavioral Health
Organization subpart
No

Provider details

NPI number
Authorized official
EARL ROBINSON (LEECH LAKE HUMAN SERVICES DIRECTOR)
(218) 335-8295
Entity
Organization

Contact information

Practice address
16123 GRANT UTLEY AVE NW, CASS LAKE, MN 56633
(218) 335-3050
(218) 335-4410
Mailing address
115 6TH STREET NW, STE. E, CASS LAKE, MN 56633
(218) 335-3050
(218) 335-4410

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
19439
MN
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
MN

Other

Enumeration date
04/18/2011
Last updated
02/28/2020
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