FOND DU LAC RESERVATION BUSINESS COMMITTEE (NPI# 1053772087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053772087 |
| Entity Type | Organization |
| Organization Name | FOND DU LAC RESERVATION BUSINESS COMMITTEE |
| Other Organization Name | FDL HUMAN SERVICES BEHAVIORAL HEALTH |
| Practice Address |
927 Trettel Ln Cloquet MN 55720-1345 |
| Practice Telephone | 2188791227 |
| Mailing Telephone | 2188791227 |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2020-06-23 |
| Authorized Official Name | JENNIFER DUPUIS (ASSOCIATE DIRECTOR) |
| Authorized Official Telephone | 2188791227 |
| Is Organization Subpart | Y |
| Parent Organization Name | FOND DU LAC HUMAN SERVICES DIVISION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS AODA | 8F27FO | 01 |
| MN | 666815100 | 05 | |
| MN | 666815101 | 05 |
| Other Name | Type Code |
|---|---|
| FDL Human Services Behavioral Health | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134426778 | Fond Du Lac Reservation Business Committee | Assisted Living Facility | 1571 Airport Road, Fond Du Lac Assisted Living, Cloquet, MN 55720 | 2011-02-17 |
| 1629256763 | Fond Du Lac Reservation Business Committee | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 221 W 4th St, Duluth, MN 55806-2719 | 2008-01-31 |
| 1326053166 | Fond Du Lac Reservation Business Committee | Durable Medical Equipment & Medical Supplies | 927 Trettle Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2006-07-30 |
| 1346501392 | Fond Du Lac Reservation Business Committee | Pharmacy | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2012-06-06 |
| 1225335862 | Fond Du Lac Reservation Business Committee | Clinic/Center | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2011-02-17 |
| 1700064714 | Fond Du Lac Reservation Business Committee | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 2020 Bloomington Ave, Minneapolis, MN 55404-3073 | 2008-02-01 |
| Street Address |
927 TRETTEL LN |
| City | CLOQUET |
| State | MN |
| Zip Code | 55720-1345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427044239 | Janette Mary Setterquist | Registered Nurse | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2005-09-27 |
| 1568070498 | York Marlowe | Counselor | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2020-07-16 |
| 1972149623 | Abigail Nancy Anderson | Physician Assistant | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2019-11-18 |
| 1245897438 | Sophia Stangl | Dentist | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2019-05-22 |
| 1386201572 | Shelia Marie Miller | Social Worker | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2019-05-22 |
| 1598246142 | Leann Mae Butler | Nurse Practitioner | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2018-08-22 |
| 1093200826 | Robert Alexander Johnson | Dentist | 927 Trettel Ln, Cloquet, MN 55720 | 2018-06-25 |
| 1780173534 | Ariane Marene Norrgard | Social Worker | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2018-05-08 |
| 1811405368 | Barbara Ann Heikkila | Dietitian, Registered | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2018-01-18 |
| 1659886026 | Katherine Gokee | Health Educator | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2017-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447786652 | Awakening Growth, LLC | Social Worker | 116 Ave C, Cloquet, MN 55720 | 2017-05-08 |
| 1396129706 | Kara Danielle Ebert | Marriage & Family Therapist | 913 Stanley Ave, Cloquet, MN 55720 | 2015-07-15 |
| 1639577729 | Fcsl Cloquet, LLC | Assisted Living Facility | 130 W North Road, Cloquet, MN 55720 | 2014-12-05 |
| 1699173765 | Fcsl Cloquet, LLC | Assisted Living Facility | 132 W North Road, Cloquet, MN 55720 | 2014-12-05 |
| 1134426778 | Fond Du Lac Reservation Business Committee | Assisted Living Facility | 1571 Airport Road, Fond Du Lac Assisted Living, Cloquet, MN 55720 | 2011-02-17 |
| 1417124553 | Kara Lynn Fausch | Family Medicine | 512 Skyline Boulevard, Cloquet, MN 55720 | 2008-05-08 |
| 1013199769 | Carlton Co Public Health & Human Services | Public Health or Welfare | 30 N 10th Street, Cloquet, MN 55720 | 2007-12-04 |
| 1881808616 | Stephen David Parkhurst | Chiropractor | 903 Cloquet Avenue, Cloquet, MN 55720 | 2007-05-10 |
| 1093929861 | Northland Afc,inc | Day Training, Developmentally Disabled Services | 1576 White Pine Trail, Cloquet, MN 55720 | 2007-05-10 |
| 1235341231 | Northland Afc,inc | Day Training, Developmentally Disabled Services | 6580 W Arrowhead Rd., Cloquet, MN 55720 | 2007-05-04 |
| Find all providers in zip 55720 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1851991160 | Gratia Counseling & Consulting, LLC | Clinic/Center | 2705 Bunker Lake Blvd Nw Ste 103, Andover, MN 55304-3786 | 2020-10-27 |
| 1508465147 | Piece of Mind Counseling Services, Pllc | Clinic/Center | 1122 Bemidji Ave N, Bemidji, MN 56601-2833 | 2020-10-24 |
| 1205433984 | Hopebridge Life Skills Center | Clinic/Center | 3617 E Lake St, Minneapolis, MN 55406-2148 | 2020-10-05 |
| 1275149007 | Clarity Counseling Services Pllc | Clinic/Center | 521 W Highway 2, Cohasset, MN 55721-2300 | 2020-09-17 |
| 1720693146 | Serene Therapy and Counseling Services LLC | Clinic/Center | 777 Berry St Apt 400b, Saint Paul, MN 55114-4006 | 2020-09-11 |
| 1427662592 | Threesixty, LLC | Clinic/Center | 4960 Miller Trunk Hwy # 600-b, Hermantown, MN 55811-1891 | 2020-09-04 |
| 1124639190 | Woodhaven Wellness | Clinic/Center | 3000 Carriage Dr, Hamel, MN 55340-9597 | 2020-08-13 |
| 1245840735 | Kalina Counseling Services | Clinic/Center | 120 7th St Unit 101, Two Harbors, MN 55616-1563 | 2020-08-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.