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Contact Information

LEECH LAKE OPIATE TREATMENT PROGRAM
110 BALSAM AVE. NW
CASS LAKE, MN56633
 Phone: 218-335-4514
 Fax: 218-335-4580
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for LEECH LAKE OPIATE TREATMENT PROGRAM

NPI Number 1578627451
LBN Legal business name LEECH LAKE OPIATE TREATMENT PROGRAM
Authorized official EARLENE BUFFALO - (PROGRAM MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/21/2006
Last updated 08/22/2020 - About 6 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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