Organization Name: | MILLE LACS BAND OF OJIBWE COMMUNITY SUPPORT SERVICES |
NPI Number: | 1407223035 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TAMMY ANN MORELAND (WRAPAROUND COORDINATOR) |
Mailing Address: | 4342 Oodena Drive Onamia |
State: | MN US |
Postal Code: | 56359 |
Phone Number: | 3202921942 |
Fax Number: | |
NPI Enumeration Date: | 08/31/2015 |
NPI Last Update Date: | 08/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 347C00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Private Vehicle |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |