National Provider Identifier Database

RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
Federally Qualified Health Center (FQHC)

A Federally Qualified Health Center (FQHC) is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status.


Contact Information

RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
36745 AIKEN RD
BAYFIELD, WI54814-4579
Phone: 715-779-3707
Fax: 715-779-3362
Website:
Specialty Taxonomy Code
* Federally Qualified Health Center (FQHC) 261QF0400X
Addiction (Substance Use Disorder) 101YA0400X
Ambulance 341600000X
Clinical 1041C0700X
Dental 261QD0000X
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacist 183500000X
Primary Care 261QP2300X
Registered Nurse 163W00000X

* Indicates primary specialty

NPI Profile & details for RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA INDIANS

NPI Number 1497744015
Legal business name
LBN
RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
Authorized official DIANE ERICKSON - (HEALTH SERVICES ADMINISTRATOR)
Entity Organization
Organization subpart Yes
Enumeration date 10/17/2005
Last updated 02/24/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • WI License #: 32956200
  • WI Medicaid: 32956200
  • WI Medicaid: 44004200
  • Other: 10170-001 GROUP PLAN # DENTAL
  • Other: CS3144 RR RETIREMENT PALMETTO

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA INDIANS

There are currently no reviews for RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA INDIANS


NPIdb - Home
v2.201