Healthcare Provider Details

I. General information

NPI: 1144353343
Provider Name (Legal Business Name): DEPARTMENT OF HUMAN SERVICES &PHS, IHS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 7TH ST NW
CASS LAKE MN
56633-3360
US

IV. Provider business mailing address

425 7TH ST NW
CASS LAKE MN
56633-3360
US

V. Phone/Fax

Practice location:
  • Phone: 218-335-3200
  • Fax:
Mailing address:
  • Phone: 218-335-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0904X
TaxonomyFederal Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JOANNA MARIE FERRARO
Title or Position: HEALTH SYSTEMS ADMINISTRATOR
Credential:
Phone: 218-335-3200