NPIMap

Organization Active NPI

Leech Lake Band of Ojibwe

Doing business as Ahnji-Be-Mah-Diz Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Cass Lake, MN
National Provider Identifier
1801065495
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
LEECH LAKE BAND OF OJIBWE
Doing business as
Ahnji-Be-Mah-Diz Recovery Center
Practice address
16599 69TH Avenue NW
Cass Lake, MN 56633
Phone
(218) 335-6880
Fax
(218) 335-7760
NPI assigned
Feb 27, 2008
Last updated
Jul 9, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
LEECH LAKE BAND OF OJIBWEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Earl Robinson
Title
Human Services Director
Phone
(218) 335-8295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

16599 69TH Avenue NW
Cass Lake, MN 56633

Mailing address

190 Sailstar Dr NW
Cass Lake, MN 56633
Phone (218) 335-6880

Other names 1

  • Ahnji-Be-Mah-Diz Recovery Center Doing business as

National Provider Directory

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

Other organizations with this tax ID 18

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

View all 18

Locations

16427 69th Ave NW
Cass Lake, MN 56633

16599 69th Ave NW
Cass Lake, MN 56633
Phone (218) 335-6880

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1801065495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 SAILSTAR DR NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-335-6880",
            "fax_number": "218-335-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16599 69TH AVENUE NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-335-6880",
            "fax_number": "218-335-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEECH LAKE BAND OF OJIBWE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEECH LAKE BAND OF OJIBWE",
        "enumeration_date": "2008-02-27",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "EARL",
        "authorized_official_title_or_position": "HUMAN SERVICES DIRECTOR",
        "authorized_official_telephone_number": "218-335-8295"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ahnji-Be-Mah-Diz Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 9, 2020; 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.