FOUR WINDS LODGE – NPI #1285186007
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.

FOUR WINDS LODGE is a substance abuse rehabilitation facility located in BRAINERD, MN. NPPES has assigned the NPI number 1285186007 to FOUR WINDS LODGE on October 27, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FOUR WINDS LODGE” is a dba name, the actual legal business name for this organization is MILLE LACS BAND OF OJIBWE INDIANS. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

The NPI profile was previously updated about 5 years ago on Oct 14, 2021. 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 FOUR WINDS LODGE below.

NPI Profile for
MILLE LACS BAND OF OJIBWE INDIANS

NPI Number
1285186007
Enumeration Date

(more than 9 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
MILLE LACS BAND OF OJIBWE INDIANS
Doing Business As (dba): FOUR WINDS LODGE
Primary location
11600 STATE AVE
BRAINERD, MN 56401
Phone: (320) 532-4163 Fax:
Mailing address
18562 MINOBIMAADIZI LOOP
ONAMIA, MN 56359-3001
Phone: (320) 532-4163 Fax: (320) 532-7495
Organization Subpart
Yes - FOUR WINDS LODGE is subpart of another organization.
Authorized Official
NICOLE ANDERSON
HHS COMMISSIONER
Phone: (320) 532-4163
Updated
Certification Date
Oct 14, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

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
324500000X
- Substance Abuse Rehabilitation Facility (Primary)

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.