Red Lake Chemical Health Programs Outpatient

NPI #1881802411 in Redlake, Minnesota

Provider Information

NPI Number: 1881802411
Entity Type: Organization
Organization Name: Red Lake Chemical Health Programs Outpatient
Primary Specialty: Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Enumeration Date: May 18, 2007
Last Updated: Mar 27, 2019

Practice Location

Address: 15797 MAIN AVE
Address 2: HWY 1
City: Redlake
State: Minnesota
ZIP Code: 56671-0114
Phone: (218) 679-3392

Authorized Official

Name: SALENA L BRANCHAUD
Title: PROGRAM MANGER
Phone: (218) 679-3392

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy	332800000X	Primary

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