location
search-icon
institution
Red Lake Detention Outpatient
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Red Lake, Minnesota
NPI 1003332057

Red Lake Detention Outpatient is a Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy based in Red Lake, MN. Red Lake Detention Outpatient practices in Red Lake, MN. The NPI Number for Red Lake Detention Outpatient is 1003332057 and holds a License No. (Minnesota).

The current practice location address for Red Lake Detention Outpatient is 25064 Highway 1 East, Red Lake, MN and can be reached out via phone at 218-679-3995 and via fax at 218-679-3976.

Location: 25064 Highway 1 East, Red Lake, MN, 56671
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1003332057
Provider Name
Red Lake Detention Outpatient
Credential
Provider Entity Type
Organization
Address
25064 Highway 1 East, Red Lake, MN, 56671
Phone Number
218-679-3995
Fax Number
218-679-3976
Provider Enumeration Date
08/21/2017
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1001 01 MN TRIBAL LICENSE
institution
Provider Business Practice Location Address Details
Address
25064 Highway 1 East
City
Red Lake
State
Minnesota
Zip
56671
Phone Number
218-679-3995
Fax Number
218-679-3976
person
Provider Business Mailing Address Details
Address
25064 Highway 1 East
City
Red Lake
State
Minnesota
Zip
56671
Phone Number
218-679-3995
Fax Number
218-679-3976
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
()
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Speciality
-
Taxonomy
332800000X
License No.
()
Definition
An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.
semi-verified symbol
Badge

Use the following badge on your website to showcase your NPI number and verified status. In a field with over 8 million healthcare providers in the United States, it is important to establish your identity clearly. Displaying this badge signifies that your information is both accurate and up-to-date.