Organization · Type 2 NPI

Mille Lacs Band of Ojibwe Indians

Substance Abuse Rehabilitation Facility · Brainerd, MN

NPI number 1285186007 Active

Practice location

11600 State Ave
Brainerd, MN 56401

Call (320) 532-4163 Map

Mailing address

18562 Minobimaadizi Loop
Onamia, MN 56359-3001

Specialties and licenses

Taxonomy	Code	License
Substance Abuse Rehabilitation Facility Primary	324500000X	None listed

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

2 other providers at this address

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NPI record

NPI: 1285186007
Entity type: Organization (Type 2)
Issued: Oct 27, 2016
Last updated: Oct 14, 2021
Status: Active
Subpart: Yes of Mille Lacs Band of Ojibwe Indians

Other names

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Four Winds Lodge · doing business as

Authorized official

Nicole Anderson
HHS Commissioner
(320) 532-4163

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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 1285186007

Mille Lacs Band of Ojibwe Indians's National Provider Identifier is 1285186007, issued on Oct 27, 2016. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Brainerd, MN. The record was last updated on Oct 14, 2021.