OrganizationActive
Leech Lake Outpatient Treatment Program
NPI 1275701666 · Addiction (Substance Use Disorder) Counselor · Cass Lake, MN
Provider details
- NPI number
- 1275701666
- Entity type
- Organization
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Parent organization
- Leech Lake Band of Ojibwe
- Organization subpart
- Yes
- Authorized official
- Gloria Mellado, A & D Program Director(218) 335-3567
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6095 161st Ave Nw
Cass Lake, MN 56633-3428
Phone: (218) 335-8308
Fax: (218) 335-8307
Street-level locationGet directions
Mailing address
6905 161st St. Nw
Cass Lake, MN 56633-3428
Registry dates
- Enumerated
- 2008-02-19
- Last updated
- 2008-07-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.