NPIMap

Organization Active NPI

Lac Du Flambeau Band of Lake Superior Chippewa Indians

  • Community/Behavioral Health Agency
  • Lac Du Flambeau, WI
National Provider Identifier
1861885014
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
3071 Issued in WI
Legal business name
LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
Practice address
533 Peace Pipe Rd
Lac Du Flambeau, WI 54538-9123
Phone
(715) 588-1511
NPI assigned
Mar 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Anthony J Ernst, PHD,LMSW-ACP
Title
Human Services Director
Phone
(715) 588-1511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 3071 WI Primary

Addresses

Primary practice location

533 Peace Pipe Rd
Lac Du Flambeau, WI 54538-9123

Mailing address

533 Peace Pipe Rd
PO Boc 189
Lac Du Flambeau, WI 54538-9123
Phone (715) 588-1511

Other names 1

  • LDFHHS Provider Network Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lac Du Flambeau Band of Lake Superior Chippewa Indians3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

533 Peace Pipe Rd
Lac du Flambeau, WI 54538
Phone (715) 588-1511

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1861885014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 PEACE PIPE RD",
            "address_2": "PO BOC 189",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545389123",
            "telephone_number": "715-588-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 PEACE PIPE RD",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545389123",
            "telephone_number": "715-588-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-12",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "ERNST",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "HUMAN SERVICES DIRECTOR",
        "authorized_official_telephone_number": "715-588-1511",
        "authorized_official_credential": "PHD,LMSW-ACP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "3071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LDFHHS Provider Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lac Du Flambeau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; 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.