LEECH LAKE OPIATE TREATMENT PROGRAM
NPI 1053478164
Preferred Provider Organization in Cass Lake, MN

Active since January 02, 2007
110 BALSAM AVE. NW, CASS LAKE, MN 56633(218) 335-4514(218) 335-4580 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Leech Lake Opiate Treatment Program NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEECH LAKE OPIATE TREATMENT PROGRAM (NPI 1053478164) is a healthcare organization registered as a preferred provider organization in Cass Lake, Minnesota and active in the NPI registry since January 2007. The organization lists Earlene Buffalo, Program Manager, as its authorized official.

NPPES Registry Identity

NPI1053478164
Entity TypeOrganization
Primary Taxonomy305R00000X
Legal Business NameLEECH LAKE OPIATE TREATMENT PROGRAM
Location Address110 BALSAM AVE. NWCass Lake, MN 56633
Mailing Address115 6th St Ne, Suite ECass Lake, MN 56633-3428 · (218) 335-4514 · Fax (218) 335-4580
Fax(218) 335-4580
Organization SubpartNo
Authorized OfficialEarlene BuffaloProgram Manager · (218) 335-8304
Enumeration DateJanuary 2, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1053478164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPreferred Provider OrganizationManaged Care Organizations
Taxonomy Code305R00000X
Definition

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.

110 BALSAM AVE. NW, Cass Lake, MN 56633

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Preferred Provider Organization
110 BALSAM AVE. NW
CASS LAKE, MN 56633

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053478164, enumerated as an "organization" on January 02, 2007.

The provider is located at 110 BALSAM AVE. NW CASS LAKE, MN 56633 and the phone number is (218) 335-4514.

Preferred Provider Organization with taxonomy code 305R00000X.