| Red Lake Nation Youth Safe Harbor Inc | |
|
15834 Pill Hill Avenue Red Lake MN 56671-0590 | |
| (218) 679-6071 | |
| Not Available |
| Full Name | Red Lake Nation Youth Safe Harbor Inc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 15834 Pill Hill Avenue, Red Lake, Minnesota |
| Authorized Official Name and Position | Charlene Andersen (REVENUE GENERATION MANAGER) |
| Authorized Official Contact | 2186791320 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Red Lake Nation Youth Safe Harbor Inc Po Box 590 Redlake MN 56671-0590 Ph: (218) 679-6071 | Red Lake Nation Youth Safe Harbor Inc 15834 Pill Hill Avenue Red Lake MN 56671-0590 Ph: (218) 679-6071 |
| NPI Number | 1851036123 |
|---|---|
| Provider Enumeration Date | 05/02/2022 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851036123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
Mino-miikanaang Bima'adoo Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14468 Little Rock St., Red Lake, MN 56671 Phone: 218-368-2472 | |
Red Lake Medication Assisted Recovery Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 24760 Hospital Drive, Red Lake, MN 56671 Phone: 218-679-3995 Fax: 218-679-3976 | |
Endazhi-nitaawiging Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 25065 Hwy 1 West, Red Lake, MN 56671 Phone: 218-308-4164 |