FOND DU LAC RESERVATION BUSINESS COMMITTEE (NPI# 1225335862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225335862 |
| Entity Type | Organization |
| Organization Name | FOND DU LAC RESERVATION BUSINESS COMMITTEE |
| Other Organization Name | FDL ADULT OUTPATIENT TX |
| Practice Address |
927 Trettel Lane Fond Du Lac Human Services Division Cloquet MN 55720 |
| Practice Telephone | 2188791227 |
| Practice Fax Number | 2188783755 |
| Mailing Telephone | 2188791227 |
| Mailing Fax Number | 2188783755 |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2016-10-10 |
| Authorized Official Name | MS. MARILYN GROVER (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 | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
012010 | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1326053166 | 05 |
| Other Name | Type Code |
|---|---|
| FDL Adult Outpatient Tx | Doing Business As Name - 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 |
| 1053772087 | Fond Du Lac Reservation Business Committee | Clinic/Center | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2016-03-18 |
| 1346501392 | Fond Du Lac Reservation Business Committee | Pharmacy | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2012-06-06 |
| 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 LANE FOND DU LAC HUMAN SERVICES DIVISION |
| City | CLOQUET |
| State | MN |
| Zip Code | 55720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912961228 | Mollie A Stapleton | Family Medicine | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2006-04-13 |
| 1457669764 | Debra Marie Smith | Registered Nurse | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2010-09-21 |
| 1881906287 | Jamie Wade | Dentist | 927 Trettel Lane, Fond Du Lac Human Services Division927 Trettel Lane, Cloquet, MN 55720 | 2010-07-14 |
| 1063723138 | Fond Du Lac Reservation Business Committe | Clinic/Center | 927 Trettel Lane, Fond Du Lac Human Services Division Dental Clinic, Cloquet, MN 55720 | 2010-06-23 |
| 1770725582 | Ben Earl Anderson | Pharmacist | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720-8247 | 2009-03-26 |
| 1700026143 | Jamie Johanna Kraus | Pharmacist | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2009-02-25 |
| 1225278674 | Jessica Anne Linde | Pharmacist | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2009-02-25 |
| 1205090321 | Jeanne Rice | Optometrist | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2008-07-17 |
| 1598928681 | Elenore C Schoenfeld | Counselor | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2008-07-08 |
| 1184887267 | Jeffery Agoton-howes | Social Worker | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2008-07-08 |
| 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 | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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|---|---|---|---|---|
| 1093340036 | Humble Recovery | Clinic/Center | 1156 Aldrich Ave N, Minneapolis, MN 55411-4248 | 2020-03-10 |
| 1366096307 | Centered On Youth | Clinic/Center | 3210 Oliver Ave N, Minneapolis, MN 55412-2316 | 2019-07-29 |
| 1881250785 | Adap Consulting | Clinic/Center | 1605 Southcross Dr W Ste B, Burnsville, MN 55306-7013 | 2019-05-15 |
| 1821550005 | Coscarelli Consulting, LLC | Clinic/Center | 1687 Woodlane Dr Ste 2002, Woodbury, MN 55125-3063 | 2019-04-04 |
| 1669943908 | Capital Health Services LLC | Clinic/Center | 680 Mendelssohn Ave N, Golden Valley, MN 55427-4306 | 2018-12-16 |
| 1013497916 | Thrive Behavioral Network Iv, LLC | Clinic/Center | 119 Friberg Ave, Suite B, Fergus Falls, MN 56537-2251 | 2018-08-20 |
| 1780186130 | Alliance Wellness Clinic Inc. | Clinic/Center | 8040 Old Cedar Ave. S. Ste. 100, Bloomington, MN 55425-1211 | 2018-03-01 |
| 1447795596 | Conceptual Counseling & Assessment | Clinic/Center | 151 W Burnsville Pkwy Ste 101, Burnsville, MN 55337-2525 | 2016-12-28 |
| 1871035568 | No Other Way (now) Recovery Services LLC | Clinic/Center | 1614 W 3rd St, Red Wing, MN 55066-2086 | 2016-11-11 |
| 1104374073 | Lakes Opioid Treatment Program, Inc | Clinic/Center | 8381 Lake Land Trl Nw, Walker, MN 56484-2109 | 2016-09-20 |
| 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.