Organization
RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
Active
Parent organization
RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
Other names
Red Cliff Community Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
Authorized official
MS. DIANE ERICKSON (HEALTH SERVICES ADMINISTRATOR)
(715) 779-3707
Entity
Organization
Contact information
Practice address
36745 AIKEN RD, BAYFIELD, WI 54814-4579
(715) 779-3707
(715) 779-3362
Mailing address
36745 AIKEN RD, BAYFIELD, WI 54814-4579
(715) 779-3707
(715) 779-3362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
—
WI
163W00000X
Registered Nurse
—
WI
183500000X
Pharmacist
—
—
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
32956200
WI
261QP2300X
Primary Care Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
WI
341600000X
Ambulance
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10170-001
GROUP PLAN # DENTAL
—
05
—
32956200
—
WI
05
—
44004200
—
WI
01
—
CS3144
RR RETIREMENT PALMETTO
—
Enumeration date
10/17/2005
Last updated
02/24/2023
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