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Contact Information

LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
3378 N. SCHILLEMAN RD
LAC DU FLAMBEAU, WI54538-0815
 Phone: 715-388-0762
 Fax: 715-588-1889
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health (Including Community Mental Health Center)

261QM0801X B4[14] Community Mental Health Center
 

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
 

Substance Abuse Disorder Rehabilitation Facility

324500000X
Indicates primary specialty

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

NPI # 1669970729
LBN Legal business name LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
Authorized official PAMELA AHLBORN - (COMPLIANCE & CONTRACT COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/24/2018
Last updated 09/13/2018 - About 8 years ago
Identifiers
WI License # 3100
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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