WARRIOR DOWN - PEER RECOVERY SUPPORT NPI 1003332057

NPI Information

  • NPI: 1003332057
  • Provider Name: WARRIOR DOWN - PEER RECOVERY SUPPORT
  • Classification: Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy - 332800000X
  • Entity Type: Organization
  • Former Legal Business Name: RED LAKE DETENTION OUTPATIENT
  • Address: 15533 MAIN AVENUE
    RED LAKE, MN
    ZIP 56671
  • Phone: (218) 679-3392

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NPI Details

WARRIOR DOWN - PEER RECOVERY SUPPORT is an indian health service tribal urban indian health i t u pharmacy in Red Lake, MN. The provider is an Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. WARRIOR DOWN - PEER RECOVERY SUPPORT NPI is 1003332057. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Red Lake Detention Outpatient.

The provider's business location address is:

15533 MAIN AVENUE
RED LAKE, MN
ZIP 56671-114
Phone: (218) 679-3392

The provider's authorized official is Salena Beasley .
The authorized official title is Admin Officer and has the following contact phone number (218) 679-3392.

The enumeration date for this NPI number is 8/21/2017 and was last updated on 11/27/2024.

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
1324500000XSubstance Abuse Rehabilitation FacilityNo
2332800000XIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyYes

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
11001OTHERMINNESOTATRIBAL LICENSE

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: 3/30/2025

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