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Contact Information

LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
128 OLD ABE RD
LAC DU FLAMBEAU, WI54538-9682
 Phone: 715-588-4466
 Fax: 715-588-2269
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dental

261QD0000X
 

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

NPI Profile & details for LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS

NPI Number 1427347426
LBN Legal business name LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
Authorized official JEANNE WOLFE - (COMPLIANCE OFFICER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 03/31/2011
Last updated 01/28/2014 - About 12 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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