FOND DU LAC RESERVATION BUSINESS COMMITTEE (NPI# 1326053166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326053166 |
| Entity Type | Organization |
| Organization Name | FOND DU LAC RESERVATION BUSINESS COMMITTEE |
| Other Organization Name | FOND DU LAC HUMAN SERVICES DIVISION |
| Practice Address |
927 Trettle Lane Fond Du Lac Human Services Division Cloquet MN 55720 |
| Practice Telephone | 2188791227 |
| Practice Fax Number | 2188783800 |
| Mailing Telephone | 2188791227 |
| Mailing Fax Number | 2188783800 |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2016-02-02 |
| Authorized Official Name | MS. MARILYN GROVER (ASSOCIATE DIRECTOR) |
| Authorized Official Telephone | 2188791227 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 5985000001 | MN | Suppliers |
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
012003 | MN | Ambulatory Health Care Facilities |
| Y | 261Q00000X | Clinic/Center | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 666815101 | 05 | |
| MN | BCBS AODA | 8F27FO | 01 |
| MN | 666815100 | 05 |
| Other Name | Type Code |
|---|---|
| Fond du Lac Human Services Division | 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 |
| 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 |
| 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 TRETTLE LANE FOND DU LAC HUMAN SERVICES DIVISION |
| City | CLOQUET |
| State | MN |
| Zip Code | 55720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780730523 | Gregory B Goodrich | Psychologist | 927 Trettle Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2007-01-26 |
| 1063598035 | June Denise Mclachlan | Nurse Practitioner | 927 Trettle Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2006-10-31 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770516890 | Raiter Clinic, Ltd. | Clinic/Center | 417 Skyline Boulevard, Cloquet, MN 55720-1198 | 2006-07-09 |
| 1306144100 | Leno Chiropractic Clinic Ltd | Clinic/Center | 123 Avenue C, Cloquet, MN 55720-1563 | 2011-03-03 |
| 1346447471 | Aspenridge Chiropractic Center P.a. | Clinic/Center | 2511 Washington Ave, Cloquet, MN 55720-2845 | 2007-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191403 | Cham Clinic LLC | Clinic/Center | 7362 University Ave Ne Ste 206, Fridley, MN 55432-3151 | 2020-10-15 |
| 1003434622 | Lost Lake Optical Company | Clinic/Center | 5240 Shady Island Cir, Mound, MN 55364-9222 | 2020-07-09 |
| 1811513310 | Prescribed By LLC | Clinic/Center | 701 Washington Ave N Ste 111-321, Minneapolis, MN 55401-2822 | 2020-06-19 |
| 1992320014 | Jtp Professional Service Corporation | Clinic/Center | 2038 Ford Pkwy # 444, Saint Paul, MN 55116-1931 | 2020-06-15 |
| 1689299125 | Altru Health System | Clinic/Center | 1st & Roosevelt, Karlstad, MN 56732 | 2020-06-10 |
| 1831710409 | Webmed LLC | Clinic/Center | 925 E Superior St Ste 113, Duluth, MN 55802-2253 | 2020-05-05 |
| 1073149779 | Functional Chiropractic Rehab, Pllc | Clinic/Center | 1901 Madison Ave Ste 120, Mankato, MN 56001-6267 | 2020-03-14 |
| 1225676067 | Liana Healthcare P.ll.c | Clinic/Center | 8348 Beard Rd, Bloomington, MN 55431-1028 | 2019-12-11 |
| 1245875293 | Fairview Clinics | Clinic/Center | 12912 Farnham Ave N, White Bear Lake, MN 55110-5929 | 2019-11-14 |
| 1275175242 | Hye-kyong Kim Therapy LLC | Clinic/Center | 1145 Grand Ave # 101, Saint Paul, MN 55105-2629 | 2019-10-11 |
| 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.