Red Lake Detention Outpatient
LBN: Red Lake Detention Outpatient
Red Lake Detention Outpatient is an health care organization with primary practice located at 25064 Highway 1 East , Red Lake MN 56671. The organization recently has 2 registered licenses in different health care specialties including Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy. Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy is the primary health care specialty.
Red Lake Detention Outpatient can be contacted via phone (218) 679-3995, or through Gonzalez-Rivera, Reyna Cruz via phone (218) 679-3392.
Contact Information
Primary practice address
25064 Highway 1 East
Red Lake MN 56671
Phone: (218) 679-3995
Fax: (218) 679-3976
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Substance Abuse Rehabilitation Facility | 324500000X | ||
| Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X |
Profile Details
| NPI number | 1003332057 |
|---|---|
| LBN Legal business name | Red Lake Detention Outpatient |
| DBA Doing business as | Red Lake Detention Outpatient |
| Authorized official | Gonzalez-Rivera, Reyna Cruz |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 21st, 2017 |
| Last updated | Mar 20th, 2019 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003332057 | NPPES |
| Minnesota | Other | 1001 | TRIBAL LICENSE |
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