NPIMap

Organization Active NPI

Leech Lake Band of Ojibwe

  • Public Health or Welfare Agency
  • Cass Lake, MN
National Provider Identifier
1194909085
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
LEECH LAKE BAND OF OJIBWE
Practice address
120 2ND St NW
Cass Lake, MN 56633
Phone
(218) 335-4500
Fax
(218) 335-4513
NPI assigned
Dec 27, 2007
Last updated
Dec 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joel Bebeau
Title
Interim Director
Phone
(218) 335-4500

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Public Health or Welfare Agency 251K00000X NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Home Delivered Meals 332U00000X NU
Non-emergency Medical Transport (VAN) 343900000X NU
Private Vehicle 347C00000X NU

Addresses

Primary practice location

120 2ND St NW
Cass Lake, MN 56633

Mailing address

115 6TH St. NW
Suite E
Cass Lake, MN 56633
Phone (218) 335-4500

Other names 1

  • LEECH LAKE RESERVATION-HEALTH Other name

National Provider Directory

National Provider Directory
Tax ID family
Leech Lake Outpatient Treatment Program19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

120 2nd St NW
Cass Lake, MN 56633
Phone (218) 335-4500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1194909085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 6TH ST. NW",
            "address_2": "SUITE E",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-335-4500",
            "fax_number": "218-335-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 2ND ST NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-335-4500",
            "fax_number": "218-335-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEECH LAKE BAND OF OJIBWE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "BEBEAU",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "INTERIM DIRECTOR",
        "authorized_official_telephone_number": "218-335-4500"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEECH LAKE RESERVATION-HEALTH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cass Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.