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White Earth Band of Chippewa

Organization Active NPI Community/Behavioral Health Agency · White Earth, MN

NPI 1093898660 · NPPES record last updated Nov 16, 2015

Key facts

NPI
1093898660
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
961994100 (MN)
Legal business name
WHITE EARTH BAND OF CHIPPEWA
Practice address
26246 Crane Rd
White Earth, MN 56591-9998
Phone
(218) 983-3286
Fax
(218) 983-4236
NPI assigned
Oct 24, 2006
Organization subpart
No

Authorized official

Name
Amy Nathe
Title
Clinical Treatment Director
Phone
(218) 983-3286

Corporate family (same tax ID) 25

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
White Earth Oshki Manidoo New Spirit Center (26 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 961994100 MN
Community/Behavioral Health Agency 251S00000X 961994100 MN Yes
Adult Mental Health Clinic/Center 261QM0850X MN
Adolescent and Children Mental Health Clinic/Center 261QM0855X MN

Addresses

Primary practice location

26246 Crane Rd
White Earth, MN 56591-9998

Mailing address

PO Box 300
White Earth, MN 56591-0300
Phone (218) 983-3286

Other identifiers

IdentifierTypeStateIssuer
961994100MedicaidMN

Other names

  • White Earth Mental Health Program Doing business as

Other providers in White Earth, MN

All providers in White Earth, MN · Community/Behavioral Health Agency in Minnesota

Sources for this page

Verify at the official NPI Registry.