| Mille Lacs Band Of Ojibwe Indians | |
|
45741 Grace Lake Road Sandstone MN 55072-3203 | |
| (320) 384-0149 | |
| (320) 384-0916 |
| Full Name | Mille Lacs Band Of Ojibwe Indians |
|---|---|
| Speciality | Clinic/Center |
| Location | 45741 Grace Lake Road, Sandstone, Minnesota |
| Authorized Official Name and Position | Nicole Anderson (COMMISSIONER OF HEALTH & HUMAN SERV) |
| Authorized Official Contact | 3205324163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mille Lacs Band Of Ojibwe Indians 18562 Minobimaadizi Loop Onamia MN 56359 Ph: (320) 532-4163 | Mille Lacs Band Of Ojibwe Indians 45741 Grace Lake Road Sandstone MN 55072-3203 Ph: (320) 384-0149 |
| NPI Number | 1831385509 |
|---|---|
| Provider Enumeration Date | 09/17/2007 |
| Last Update Date | 08/10/2020 |
| Medicare PECOS PAC ID | 5991869471 |
|---|---|
| Medicare Enrollment ID | O20090128000174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831385509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Selah Wellness Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 501 Main Street, Sandstone, MN 55072 Phone: 320-372-2323 | |
Selah Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Main St, Sandstone, MN 55072 Phone: 320-372-2312 |