FDL ADOLESCENT OUTPATIENT TX
NPI 1447606959
Clinic/Center - Adolescent and Children Mental Health in Cloquet, MN
NPI Status: Active since May 13, 2016
Contact Information
927 TRETTEL LN
CLOQUET, MN
ZIP 55720
Phone: (218) 879-1227
- Organization
- Clinic/Center
- Adolescent and Children Mental Health
- CLIA Number: 24D2151041
- CLIA Cert. Type: Health Fair
- CLIA Exp. Date: 07-09-2026
About FDL ADOLESCENT OUTPATIENT TX
This page provides the complete NPI Profile along with additional information for Fdl Adolescent Outpatient Tx, a provider established in Cloquet, Minnesota operating as a Clinic/center, focusing in adolescent and children mental health . The healthcare provider is registered in the NPI registry with number 1447606959 assigned on May 2016. The practitioner's primary taxonomy code is 261QM0855X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's former legal business name is Fond Du Lac Reservation Business Committee. The authorized official of this NPI record is Marilyn Grover (Associate Director)
- NPI
- 1447606959
- Provider Legal Name
- FDL ADOLESCENT OUTPATIENT TX
- Other Organization Name
- FOND DU LAC RESERVATION BUSINESS COMMITTEE
- Other Name Type
- Former Legal Business Name (4)
- Entity Type
- Organization
- Location Address
- 927 TRETTEL LN CLOQUET, MN 55720
- Location Phone
- (218) 879-1227
- Mailing Address
- 927 TRETTEL LN CLOQUET, MN 55720
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-13-2016
- Last Update Date
- 10-10-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Adolescent and Children Mental Health
- Taxonomy Code
- 261QM0855X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 666815101 | MEDICAID (05) | MN | |
| 666815100 | MEDICAID (05) | MN | |
| 8F27F0 | OTHER (01) | MN | BCBS AODA |
| 5985000001 | MEDICARE NSC (07) | MN | |
| C06351 | MEDICARE PIN (08) | MN |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 24D2151041
- Facility Type
- Health Fair
- Certificate Effective Date
- July 10, 2024
- Certificate Expiration Date
- July 09, 2026
- Laboratory Director
- LISA M. HOLLINDAY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fdl Adolescent Outpatient Tx to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1447606959, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
CLOQUET, MN 55720
CLOQUET, MN 55720
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1447606959, enumerated as an "organization" on May 13, 2016.
The provider is located at 927 TRETTEL LN CLOQUET, MN 55720 and the phone number is (218) 879-1227.
Clinic/Center with taxonomy code 261QM0855X and a focus in Adolescent and Children Mental Health.
The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.
