| Mino-miikanaang Bima'adoo | |
|
14468 Little Rock St. Red Lake MN 56671 | |
| (218) 368-2472 | |
| Not Available |
| Full Name | Mino-miikanaang Bima'adoo |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 14468 Little Rock St., Red Lake, Minnesota |
| Authorized Official Name and Position | Tashina Lerae Branchaud (OWNER) |
| Authorized Official Contact | 2183682472 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mino-miikanaang Bima'adoo Po Box 1105 Redlake MN 56671-1105 Ph: (218) 368-2472 | Mino-miikanaang Bima'adoo 14468 Little Rock St. Red Lake MN 56671 Ph: (218) 368-2472 |
| NPI Number | 1467197426 |
|---|---|
| Provider Enumeration Date | 05/03/2022 |
| Last Update Date | 05/03/2022 |
| Certification Date | 05/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467197426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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