Red Cliff Aoda Program/mishomis House

NPI #1457688863 in Bayfield, Wisconsin

Provider Information

NPI Number: 1457688863
Entity Type: Organization
Organization Name: Red Cliff Aoda Program/mishomis House
Primary Specialty: Clinic/Center - Rehabilitation, Substance Use Disorder
Enumeration Date: Nov 5, 2009
Last Updated: Nov 5, 2009

Practice Location

Address: 37390 N BRADUM RD
City: Bayfield
State: Wisconsin
ZIP Code: 54814-4832
Phone: (715) 779-3741

Authorized Official

Name: MARTIN A GORDON, CSAC/ICS
Title: PROGRAM DIRECTOR
Phone: (715) 779-3741

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Substance Abuse Rehabilitation Facility	324500000X
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X	Primary

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