MINNESOTA CHIPPEWA TRIBE ADULT DAY SERVICES (NPI# 1679933568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679933568 |
| Entity Type | Organization |
| Organization Name | MINNESOTA CHIPPEWA TRIBE ADULT DAY SERVICES |
| Practice Address |
15546 State 371 Nw Cass Lake MN 56633 |
| Mailing Address |
P.o. Box 217 15542 State 371 Nw Cass Lake MN 56633 |
| Practice Telephone | 2183393167 |
| Practice Fax Number | 2183358080 |
| Mailing Telephone | 2183358586 |
| Mailing Fax Number | 2183358080 |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-03-04 |
| Authorized Official Name | MR. GARY STEVEN FRAZER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2183358581 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
MN | Ambulatory Health Care Facilities |
| Street Address |
15546 STATE 371 NW |
| City | CASS LAKE |
| State | MN |
| Zip Code | 56633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205485430 | Jessica Rose Malterud | Registered Nurse | 416-2nd Street Nw, Cass Lake, MN 56633 | 2019-09-10 |
| 1174079917 | Stacy Ann Cederstrom | Nurse Practitioner | 425 7th Street North East, Cass Lake, MN 56633 | 2016-08-31 |
| 1073979084 | Constance J Mangiamele | Registered Nurse | 190 Sailstar Dr. Nw, Cass Lake, MN 56633 | 2016-01-06 |
| 1194193086 | Whitney Dickson | Pharmacist | 425 7th Street Northwest, Cass Lake, MN 56633 | 2015-09-09 |
| 1245669332 | Marsha Ellen Kaehne | Nurse Practitioner | 119 Aspen Ave., Cass Lake, MN 56633 | 2013-11-08 |
| 1376985952 | Home Free Care, LLC | Home Health | 310 Norway Ave. Ne, Cass Lake, MN 56633 | 2013-07-23 |
| 1831468479 | Leech Lake Band of Ojibwe | Substance Abuse Rehabilitation Facility | 113 7th Stree Nw, Cass Lake, MN 56633 | 2011-12-28 |
| 1275823742 | Leech Lake Band of Ojibwe | Community/Behavioral Health | 16123 Grant Utley Ave Nw, Cass Lake, MN 56633 | 2011-04-18 |
| 1659679843 | Leech Lake Band of Ojibwe | Community/Behavioral Health | 115 6th Street Nw, Cass Lake, MN 56633 | 2011-03-11 |
| 1831491315 | Rita Marie Schuldt | Dietitian, Registered | 115 6th St. Nw Ste. 6, Cass Lake, MN 56633 | 2010-12-03 |
| Find all providers in zip 56633 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
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| 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.