RED LAKE CHEMICAL HEALTH PROGRAMS (NPI# 1700394640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700394640 |
| Entity Type | Organization |
| Organization Name | RED LAKE CHEMICAL HEALTH PROGRAMS |
| Other Organization Name | PREGNANT WOMEN & FAMILIES OUTPATIENT |
| Practice Address |
15797 Main Ave Red Lake MN 56671-0114 |
| Mailing Address |
P.o. Box 114 Red Lake MN 56671 |
| Practice Telephone | 2186793331 |
| Practice Fax Number | 2186793302 |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2019-03-19 |
| Authorized Official Name | REYNA CRUZ GONZALEZ-RIVERA (PROJECT DIRECTOR) |
| Authorized Official Telephone | 2186793392 |
| Is Organization Subpart | Y |
| Parent Organization Name | RED LAKE CHEMICAL HEALTH PROGRAMS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | TRIBAL LICENSE | 1003 | 01 |
| Other Name | Type Code |
|---|---|
| Pregnant Women & Families Outpatient | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992213839 | Red Lake Chemical Health Programs | Substance Abuse Rehabilitation Facility | 19195 North Ponemah Road, Ponemah, MN 56666 | 2018-01-12 |
| 1578070991 | Red Lake Chemical Health Programs | Substance Abuse Rehabilitation Facility | 15566 Dakota Avenue, Redby, MN 56670 | 2018-01-08 |
| 1730696154 | Red Lake Chemical Health Programs | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 14414 Green Lake Road, Redby, MN 56670 | 2018-01-08 |
| Street Address |
15797 MAIN AVE |
| City | RED LAKE |
| State | MN |
| Zip Code | 56671-0114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063030419 | Red Lake Homeless Shelter Inc. | Case Management | 15855 Main Ave, Red Lake, MN 56671 | 2020-07-13 |
| 1376026153 | Children's Healing Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 25060 Hwy 1 East, Red Lake, MN 56671 | 2018-09-08 |
| 1003332057 | Red Lake Detention Outpatient | Substance Abuse Rehabilitation Facility | 25064 Highway 1 East, Red Lake, MN 56671 | 2017-08-21 |
| 1831642214 | Jennifer Franke | Pharmacist | 24760 Hospital Rd., Red Lake, MN 56671 | 2016-08-02 |
| 1538445978 | Hoaibac Nguyen | Pharmacist | 24760 Hospital Rd, Red Lake, MN 56671 | 2011-10-31 |
| 1639466048 | Red Lake Comprehensive Health Services | Dental Hygienist | 24809 Hospital Drive, Highway 1, Redlake, MN 56671 | 2011-07-06 |
| 1821391822 | Jill Christine Andersen | Physical Therapist | Hwy 1 Hospital Dr. Box 497, Red Lake, MN 56671 | 2010-12-13 |
| 1871802934 | Elizabeth Vivian Rose | Dentist | 24760 Hospital Dr., Red Lake, MN 56671 | 2010-10-06 |
| 1225202625 | Redlake Chemical Health Program Group Home | Substance Abuse Rehabilitation Facility | 15797 Main Avenue, Redlake, MN 56671 | 2008-04-16 |
| 1104029388 | Shannon Carl Nelson | General Acute Care Hospital | Highway 1 Box 497, Red Lake, MN 56671 | 2007-06-06 |
| Find all providers in zip 56671 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003332057 | Red Lake Detention Outpatient | Substance Abuse Rehabilitation Facility | 25064 Highway 1 East, Red Lake, MN 56671 | 2017-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948584 | Sober Living Connection | Substance Abuse Rehabilitation Facility | 11115 Minnetonka Blvd, Hopkins, MN 55305 | 2020-09-30 |
| 1730791393 | Crecer Services | Substance Abuse Rehabilitation Facility | 220 Robert St S Ste 103, Saint Paul, MN 55107-1626 | 2020-08-17 |
| 1801405584 | Bridge Recovery LLC | Substance Abuse Rehabilitation Facility | 1485 10th Avenue Ne, Sauk Rapids, MN 56379-9838 | 2020-07-28 |
| 1710505821 | Rrecovery Services | Substance Abuse Rehabilitation Facility | 867 Pierce Butler Rte, Saint Paul, MN 55104-1522 | 2020-07-06 |
| 1912520966 | Avenues, LLC | Substance Abuse Rehabilitation Facility | 1990 Suburban Ave Ste 2000, Saint Paul, MN 55119-7001 | 2020-05-26 |
| 1962022939 | Valley View Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 31591 64th Ave, Cannon Falls, MN 55009-4296 | 2020-04-20 |
| 1801420039 | Recovery Center LLC | Substance Abuse Rehabilitation Facility | 109 W James St, Paynesville, MN 56362-1216 | 2020-02-26 |
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1386277622 | Community of Recovering People | Substance Abuse Rehabilitation Facility | 1221 Wayzata Blvd E, Wayzata, MN 55391-1942 | 2020-02-14 |
| 1992366645 | One Touch of Christ Evangelistic Ministries | Substance Abuse Rehabilitation Facility | 5701 Shingle Creek Pkwy Ste 650, Brooklyn Center, MN 55430-2492 | 2019-06-24 |
| 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.