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Organization

OSHKI MANIDOO OUTPATIENT PROGRAM

Active
Parent organization
WHITE EARTH BAND OF CHIPPEWA INDIANS
Other names
Oshki Manidoo
Organization subpart
Yes

Provider details

NPI number
Legal business name
WHITE EARTH BAND OF CHIPPEWA INDIANS
Authorized official
MR. JEREMY SYVERSON MBA (ADMINISTRATOR)
(218) 751-6553
Entity
Organization

Contact information

Practice address
1741 15TH ST NW, BEMIDJI, MN 56601-8755
(218) 751-6553
(218) 751-1846
Mailing address
1741 15TH ST NW, BEMIDJI, MN 56601-8755
(218) 751-6553
(218) 751-1846

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
04/11/2016
Last updated
04/11/2016
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