Minnesota Chippewa Tribe Adult Day Services

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

MINNESOTA CHIPPEWA TRIBE ADULT DAY SERVICES

Practice address

15546 State 371 NW
Cass Lake, MN 56633

Phone

(218) 339-3167

Fax

(218) 335-8080

NPI assigned

Mar 4, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Gary Steven Frazer

Title

Executive Director

Phone

(218) 335-8581

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1679933568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 217",
            "address_2": "15542 STATE 371 NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-335-8586",
            "fax_number": "218-335-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15546 STATE 371 NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-339-3167",
            "fax_number": "218-335-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA CHIPPEWA TRIBE ADULT DAY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "FRAZER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "218-335-8581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anoshirvan Mazhari, M.D.
• Kathleen McBride, RN
• Ken McCutchan, PHARM D
• Julie Ann McFarlane, RN
• Jinny Meyer, PHARMD
• Isha Mohamud, D.O.
• Cindy Rae Molacek, MASTERS
• Rebecca Monley, PHD
• Robert Mork, DDS
• Catherine Morud, NP

• Adult Day Care Clinic/Center in Cass Lake, MN
• Providers in Cass Lake, MN by specialty
• Adult Day Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; 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.