LEECH LAKE OUTPATIENT TREATMENT PROGRAM
NPI 1275701666
Counselor - Addiction (Substance Use Disorder) in Cass Lake, MN

Q: What is Leech Lake Outpatient Treatment Program's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Active since February 19, 2008

6095 161ST AVE NW, CASS LAKE, MN 56633(218) 335-8308(218) 335-8307 Get Directions Write a Review

NPPES record last updated: July 18, 2008. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Leech Lake Outpatient Treatment Program NPPES

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

LEECH LAKE OUTPATIENT TREATMENT PROGRAM (NPI 1275701666) is a healthcare organization registered as an addiction (substance use disorder) in Cass Lake, Minnesota and active in the NPI registry since February 2008. The organization lists Gloria Mellado, A & D Program Director, as its authorized official.

NPPES Registry Identity

NPI1275701666

Entity TypeOrganization

Primary Taxonomy101YA0400X

Legal Business NameLEECH LAKE OUTPATIENT TREATMENT PROGRAM

Location Address6095 161ST AVE NWCass Lake, MN 56633-3428

Mailing Address6905 161st St. NwCass Lake, MN 56633-3428 · (218) 335-8308 · Fax (218) 335-8307

Phone(218) 335-8308

Fax(218) 335-8307

Organization SubpartYesParent: Leech Lake Band Of Ojibwe

Authorized OfficialGloria MelladoA & D Program Director · (218) 335-3567

Enumeration DateFebruary 19, 2008

Last NPPES UpdateJuly 18, 2008

✔ NPI 1275701666 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

6095 161ST AVE NW, Cass Lake, MN 56633

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leech Lake Outpatient Treatment Program's NPI number?

The NPI number for Leech Lake Outpatient Treatment Program is 1275701666. It was assigned to this organization in the NPPES registry on February 19, 2008.

Where is Leech Lake Outpatient Treatment Program located?

Leech Lake Outpatient Treatment Program is located at 6095 161st Ave NW, Cass Lake, MN 56633. The listed phone number is (218) 335-8308.

What is Leech Lake Outpatient Treatment Program's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Leech Lake Outpatient Treatment Program was last updated on July 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.