Organization · Type 2 NPI

White Earth Band of Ojibwe

Community/Behavioral Health Agency · White Earth, MN

NPI number 1073972048 Active

Practice location

26246 Crane Rd
White Earth, MN 56591-9998

Fax (218) 983-4343

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency Primary	251S00000X	None listed

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…

20 other providers at this address

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NPI record

NPI: 1073972048
Entity type: Organization (Type 2)
Issued: Feb 18, 2016
Last updated: Feb 18, 2016
Status: Active
Subpart: Yes of White Earth Band of Ojibwe

Other names

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White Earth Mat Program · doing business as

Authorized official

Jeri Jasken
Behavioral Health Director
(218) 983-4647

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1073972048

White Earth Band of Ojibwe's National Provider Identifier is 1073972048, issued on Feb 18, 2016. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in White Earth, MN. The record was last updated on Feb 18, 2016.