Organization
LEECH LAKE RESERVATION
Active
Parent organization
LEECH LAKE BAND OF OJIBWE
Other names
TRIBAL HEALTH/NON-IHS
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEECH LAKE BAND OF OJIBWE
Authorized official
JOEL BEBEAU (INTERIM HEALTH DIRECTOR)
(218) 335-4500
Entity
Organization
Contact information
Practice address
115 6TH ST NE, SUITE E, CASS LAKE, MN 56633-3428
(218) 335-4500
(218) 335-4513
Mailing address
115 6TH ST NE, SUITE E, CASS LAKE, MN 56633-3428
(218) 335-4500
(218) 335-4513
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/24/2007
Last updated
10/24/2007
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