Organization
RED LAKE NATION YOUTH SAFE HARBOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLENE ANDERSEN (REVENUE GENERATION MANAGER)
(218) 679-1320
Entity
Organization
Contact information
Practice address
15834 PILL HILL AVENUE, RED LAKE, MN 56671-0590
(218) 679-6071
Mailing address
PO BOX 590, REDLAKE, MN 56671-0590
(218) 679-6071
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/02/2022
Last updated
07/17/2023
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