| Bois Forte Human Services | |
|
13071 Nett Lake Road Suite B Nett Lake MN 55772 | |
| (218) 757-3295 | |
| (218) 757-0234 |
| Full Name | Bois Forte Human Services |
|---|---|
| Speciality | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy |
| Location | 13071 Nett Lake Road, Nett Lake, Minnesota |
| Authorized Official Name and Position | Lynette Tahtinen (DATA & FINANCE SPECIALIST) |
| Authorized Official Contact | 2187573295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bois Forte Human Services 5219 St John Drive Nett Lake MN 55772-8232 Ph: (218) 757-3295 | Bois Forte Human Services 13071 Nett Lake Road Suite B Nett Lake MN 55772 Ph: (218) 757-3295 |
| NPI Number | 1871713321 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 05/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871713321 | NPI | - | NPPES |
| 004218800 | Other | MN | 101YA0400X |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 332800000X | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy | (* (Not Available)) | Primary |
Bois Forte Reservation Tribal Government Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5219 St. John Dr, Nett Lake, MN 55772 Phone: 218-757-3650 |