NPI 1881802411
Red Lake Chemical Health Programs Outpatient
Practice location
- Address
- 15797 Main Ave Hwy 1, Redlake, MN 56671-0114
- Phone
- (218) 679-3392
- Fax
- (218) 679-3976
- Mailing address
- PO Box 114, Redlake, MN 56671-0114
Authorised official
- Name
- Salena L Branchaud
- Title
- Program Manger
- Phone
- (218) 679-3392
Registered specialties (2)
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
Addiction (Substance Use Disorder) Counselor
Registry record
- NPI
- 1881802411
- Entity type
- Organization
- NPI issued
- 18 May 2007
- Record last updated
- 27 Mar 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.