Organization
MILLE LACS BAND OF OJIBWE INDIANS
Active
Parent organization
MILLE LACS BAND OF OJIBWE INDIANS
Other names
Aazhoomog Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
MILLE LACS BAND OF OJIBWE INDIANS
Authorized official
NICOLE ANDERSON (COMMISSIONER OF HEALTH & HUMAN SERV)
(320) 532-4163
Entity
Organization
Contact information
Practice address
45741 GRACE LAKE ROAD, SANDSTONE, MN 55072-3203
(320) 384-0149
(320) 384-0916
Mailing address
18562 MINOBIMAADIZI LOOP, ONAMIA, MN 56359
(320) 532-4163
(320) 532-7495
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/17/2007
Last updated
08/10/2020
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