Organization
LEECH LAKE OPIATE TREATMENT CENTER
Active
Parent organization
LEECH LAKE BAND OF OJIBWE
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEECH LAKE BAND OF OJIBWE
Authorized official
MRS. REBECCA WHITE LPN (PROGRAM MANAGER)
(218) 335-8304
Entity
Organization
Contact information
Practice address
108 BALSAM, LEECH OPIATE TREATMENT CENTER, CASS LAKE, MN 56633-3428
(218) 335-8304
(218) 335-4580
Mailing address
115 6TH ST. NW, LEECH LAKE BAND OF OJIBWE #E, CASS LAKE, MN 56633-3428
(218) 335-8200
(218) 335-4580
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
05125
MN
Other
Enumeration date
07/29/2009
Last updated
07/29/2009
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