RED LAKE AVIVO SUD TRIBAL HEALTH SERVICES – NPI #1740042654
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.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

RED LAKE AVIVO SUD TRIBAL HEALTH SERVICES is a substance abuse rehabilitation facility located in MINNEAPOLIS, MN. NPPES has assigned the NPI number 1740042654 to RED LAKE AVIVO SUD TRIBAL HEALTH SERVICES on January 25, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. 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.

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 RED LAKE AVIVO SUD TRIBAL HEALTH SERVICES below.

NPI Profile for
RED LAKE AVIVO SUD TRIBAL HEALTH SERVICES

NPI Number
1740042654
Enumeration Date

(more than 2 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
RED LAKE AVIVO SUD TRIBAL HEALTH SERVICES
Primary location
1900 CHICAGO AVE S
MINNEAPOLIS, MN 55404
Phone: (612) 752-8106 Fax:
Mailing address
PO BOX 566
REDLAKE, MN 56671-0566
Phone: (218) 679-1320 Fax:
Organization Subpart
No
Authorized Official
CHARLENE ANDERSEN
REVENUE MANGER
Phone: (218) 679-1320
Updated
Certification Date
Jan 25, 2024

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.