| Organization Name: | WHITE EARTH INDIAN HEALTH CENTER |
| NPI Number: | 1093761710 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRYCE J REDGRAVE (CEO) |
| Mailing Address: | 40520 County Hwy 34 White Earth Health Center Ogema |
| State: | MN US |
| Postal Code: | 56569 |
| Phone Number: | 2189834300 |
| Fax Number: | 2189836394 |
| NPI Enumeration Date: | 05/25/2006 |
| NPI Last Update Date: | 01/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP0904X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Public Health, Federal |
| Taxonomy Definition: | |