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Organization

GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS

Active
Parent organization
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS
Other names
Grand Traverse Band Behavioral Health Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS
Authorized official
MRS. REBECCA LYNN OIEN MOAM (TRIBAL MANAGER)
(231) 534-7136
Entity
Organization

Contact information

Practice address
2300 N. STALLMAN RD., PESHAWBESTOWN, MI 49682-9275
(231) 534-0709
Mailing address
2605 N. WEST BAY SHORE DR, PESHAEBESTOWN, MI 49682-9275
(231) 534-0709

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary

Other

Enumeration date
08/05/2021
Last updated
08/05/2021
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