Bad River Band of Lake Superior Tribe of Chippewa Indians Wis.

NPI #1710222989 in Ashland, Wisconsin

Provider Information

NPI Number: 1710222989
Entity Type: Organization
Organization Name: Bad River Band of Lake Superior Tribe of Chippewa Indians Wis.
Subpart: Yes (part of a larger organization)
Parent Organization: BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS.
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Nov 29, 2012
Last Updated: Jun 3, 2024

Practice Location

Address: 53585 NOKOMIS RD
City: Ashland
State: Wisconsin
ZIP Code: 54806-4272
Phone: (715) 682-7133

Authorized Official

Name: JUNE LOUISE WILLIAMS
Title: BILLING/PRC MANAGER
Phone: (715) 682-7133

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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