Provider Type Icon

LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS NPI 1306016563


NPI Information

NPI: 1306016563
Provider Name: LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS

Doing Business As: FAMILY RESOURCE CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
533 PEACE PIPE ROAD
LAC DU FLAMBEAU, WI
ZIP 54538
Phone: (715) 588-1511
Get Directions

LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS is a federally qualified health center (fqhc) clinic center in Lac Du Flambeau, WI. LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS NPI is 1306016563. The provider is registered as an organization entity type.
The provider Is Doing Business As Family Resource Center.

The provider's business location address is:

533 PEACE PIPE ROAD
LAC DU FLAMBEAU, WI
ZIP 54538-189
Phone: (715) 588-1511
Fax: (715) 588-3903

The provider's authorized official is Charmaine A Hopkins .
The authorized official title is Frc Exec. Admin Asst. and has the following contact phone number (715) 588-1511.

The enumeration date for this NPI number is 3/4/2008 and was last updated on 6/15/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251B00000XCase ManagementNo
2251S00000XCommunity/Behavioral HealthNo
3261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
142145400MEDICAIDWISCONSIN
243084300MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.