BAD RIVER AODA BEHAVIORAL HEALTH – NPI #1366618506
Clinic/Center

BAD RIVER AODA BEHAVIORAL HEALTH is an AHC clinic located in ASHLAND, WI. NPPES has assigned the NPI number 1366618506 to BAD RIVER AODA BEHAVIORAL HEALTH on May 07, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BAD RIVER AODA BEHAVIORAL HEALTH” is a dba name, the actual legal business name for this organization is BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDAINS WIS. The primary taxonomy selected by this provider is 261QM0801X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Mental Health (Including Community Mental Health Center)

The NPI profile was previously updated about 9 years ago on Feb 08, 2017. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BAD RIVER AODA BEHAVIORAL HEALTH below.

NPI Profile for
BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDAINS WIS

NPI Number
1366618506
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDAINS WIS
Doing Business As (dba): BAD RIVER AODA BEHAVIORAL HEALTH
Primary location
53585 NOKOMIS RD
ASHLAND, WI 54806-4272
Phone: (715) 682-7133 Fax: (715) 685-7857
Mailing address
Same as primary location
Organization Subpart
Yes - BAD RIVER AODA BEHAVIORAL HEALTH is subpart of another organization.
Authorized Official
DEBRA TUTOR
CLINIC ADMINISTRATOR
Phone: (715) 682-7133
Updated
Identifiers

Identifiers for BAD RIVER AODA BEHAVIORAL HEALTH

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDWI42202100
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center) (Primary)		 WI 2728

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.