Organization
WHITE EARTH FASD PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MONTE FOX (HEALTH DIRECTOR)
(218) 983-3286
Entity
Organization
Contact information
Practice address
26246 CRANE RD, WHITE EARTH, MN 56591-9998
(218) 983-3286
(218) 983-4308
Mailing address
PO BOX 348, WHITE EARTH, MN 56591-0348
(218) 983-3286
(218) 983-4308
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/20/2009
Last updated
03/14/2012
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