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Organization

LEECH LAKE TRIBAL COUNCIL

Active
Other names
Bamenim Anishinabe, Tribal Court
Organization subpart
No

Provider details

NPI number
Authorized official
CARRI JONES (TRIBAL CHAIRMAN)
(218) 335-8200
Entity
Organization

Contact information

Practice address
115 6TH ST NW STE E, CASS LAKE, MN 56633-3428
(218) 335-4446
(218) 335-3685
Mailing address
115 6TH ST NW STE E, CASS LAKE, MN 56633-3428

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
302091
MN

Other

Enumeration date
12/26/2013
Last updated
12/26/2013
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