Organization
MILLE LACS HEALTH SYSTEM
Active
Parent organization
MILLE LACS HEALTH SYSTEM
Other names
Mille Lacs Family Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MILLE LACS HEALTH SYSTEM
Authorized official
MR. JOHN W UNZEN (CFO)
(320) 532-2581
Entity
Organization
Contact information
Practice address
375 W ISLE ST, ISLE, MN 56342-2640
(320) 676-3661
(320) 676-4011
Mailing address
200 ELM ST N, PO BOX A, ONAMIA, MN 56359-7901
(320) 532-3154
(320) 532-3111
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
163WD0400X
Diabetes Educator Registered Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115807
UCARE MINNESOTA
MN
01
—
33523MI
BLUE CROSS BLUE SHIELD MINNESOTA
MN
05
—
566354700
—
MN
Enumeration date
06/30/2008
Last updated
05/13/2013
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