BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS (NPI# 1861751562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861751562 |
| Entity Type | Organization |
| Organization Name | BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS |
| Other Organization Name | BAD RIVER SOCIAL AND FAMILY SERVICES |
| Practice Address |
72772 Elm Street Odanah WI 54861-0055 |
| Mailing Address |
Po Box 55 Odanah WI 54861-0055 |
| Practice Telephone | 7156827127 |
| Practice Fax Number | 7156827883 |
| Mailing Telephone | 7156827127 |
| Mailing Fax Number | 7156827883 |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |
| Authorized Official Name | ESIE LEOSO (SOCIAL AND FAMILY SERVICES DIRECTOR) |
| Authorized Official Telephone | 7156827127 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 253J00000X | Foster Care Agency | Agencies | ||
| Y | 251B00000X | Case Management | Agencies |
| Other Name | Type Code |
|---|---|
| Bad River Social and Family Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588115018 | Bad River Band of Lake Superior Tribe of Chippewa Indians | Registered Nurse | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2016-10-19 |
| Street Address |
72772 ELM STREET |
| City | ODANAH |
| State | WI |
| Zip Code | 54861-0055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487913067 | Bad River Social & Family Services | Case Management | 72772 Elm Street, Odanah, WI 54861 | 2012-05-16 |
| 1548529274 | Kim Marie Ford | Case Management | 72772 Elm Street, Odanah, WI 54861-0055 | 2012-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639469760 | Andrea K Manzer | Registered Nurse | 303 Elm Street, Communtiy Health, Odanah, WI 54861 | 2011-04-11 |
| 1013093285 | Bad River Health Clinic | Clinic/Center | 1 Maple Street, Odanah, WI 54861 | 2006-10-31 |
| 1376835884 | Jamie Lynne Welch | Dental Hygienist | 72718 Maple Street, Bad River Health Clinic Dental, Odanah, WI 54861 | 2011-05-03 |
| 1902165582 | Carissa Livingston | Case Manager/Care Coordinator | 72772 Elm St, Odanah, WI 54861-0055 | 2012-05-16 |
| 1447332952 | Dennis James Sullivan Jr. | Surgery | 72718 Maple Street, Odanah, WI 54861-0250 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639469760 | Andrea K Manzer | Registered Nurse | 303 Elm Street, Communtiy Health, Odanah, WI 54861 | 2011-04-11 |
| 1013093285 | Bad River Health Clinic | Clinic/Center | 1 Maple Street, Odanah, WI 54861 | 2006-10-31 |
| 1447332952 | Dennis James Sullivan Jr. | Surgery | 72718 Maple Street, Odanah, WI 54861-0250 | 2006-10-20 |
| 1487913067 | Bad River Social & Family Services | Case Management | 72772 Elm Street, Odanah, WI 54861 | 2012-05-16 |
| 1376835884 | Jamie Lynne Welch | Dental Hygienist | 72718 Maple Street, Bad River Health Clinic Dental, Odanah, WI 54861 | 2011-05-03 |
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487913067 | Bad River Social & Family Services | Case Management | 72772 Elm Street, Odanah, WI 54861 | 2012-05-16 |
| 1548529274 | Kim Marie Ford | Case Management | 72772 Elm Street, Odanah, WI 54861-0055 | 2012-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700705 | Omega Prenatal Care Coordination Services LLC | Case Management | 9921 W Dean Rd, Milwaukee, WI 53224-2446 | 2020-11-06 |
| 1386243772 | Premier Care Services | Case Management | 2200 N Mayfair Rd, Wauwatosa, WI 53226-2252 | 2020-10-19 |
| 1124626544 | Child Care Matters Network Inc | Case Management | 7817 W Brown Deer Rd Ste 6, Milwaukee, WI 53223-1916 | 2020-10-16 |
| 1457959355 | Here for You Prenatal Coordination Services LLC | Case Management | 739 S 89th St, West Allis, WI 53214-2814 | 2020-10-13 |
| 1386241909 | Gloria Baxter | Case Management | 907 W Atkinson Ave, Milwaukee, WI 53206-3326 | 2020-10-06 |
| 1891301891 | Just Me & Mommy Family Services LLC | Case Management | 6830 W Villard Ave Ste 308, Milwaukee, WI 53218-3968 | 2020-09-16 |
| 1407467350 | Miranda Marie Porter | Case Management | 4760 N 22nd St, Milwaukee, WI 53209-6335 | 2020-08-13 |
| 1801407051 | Bundle of Love Prenatal LLC | Case Management | 5406 N Lovers Lane Rd, Milwaukee, WI 53225-3006 | 2020-08-12 |
| 1174133326 | Sharing Love Corporation | Case Management | 2200 N 12th St, Milwaukee, WI 53205-1320 | 2020-08-03 |
| 1851901268 | Community Work Services, Inc. | Case Management | 1402 Greenway Cross Ste 200, Madison, WI 53713-3181 | 2020-08-01 |
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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.