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Organization

BOIS FORTE RESERVATION TRIBAL COUNCIL

Active
Other names
Bois Forte Human Services
Organization subpart
No

Provider details

NPI number
Authorized official
LYNETTE TAHTINEN CPCS (DATA & FINANCE SPECIALIST)
(218) 757-3295
Entity
Organization

Contact information

Practice address
13071 NETT LAKE ROAD, SUITE B, NETT LAKE, MN 55772
(218) 757-3295
(218) 757-0234
Mailing address
5219 ST JOHN DRIVE, NETT LAKE, MN 55772-8232
(218) 757-3295
(218) 757-0235

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
251S00000X-COMMUNITY
MN
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary

Other

Enumeration date
07/28/2005
Last updated
05/16/2018
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