Lake Region Corporation | |
116 20th St Ne Devils Lake ND 58301-1616 | |
(701) 662-8786 | |
Not Available |
Full Name | Lake Region Corporation |
---|---|
Speciality | Community/behavioral Health |
Location | 116 20th St Ne, Devils Lake, North Dakota |
Authorized Official Name and Position | Sandra Svedberg (CFO) |
Authorized Official Contact | 7016628681 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lake Region Corporation 224 3rd St Nw Devils Lake ND 58301-2908 Ph: (701) 662-8681 | Lake Region Corporation 116 20th St Ne Devils Lake ND 58301-1616 Ph: (701) 662-8786 |
NPI Number | 1487251153 |
---|---|
Provider Enumeration Date | 10/06/2020 |
Last Update Date | 10/06/2020 |
Certification Date | 10/02/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487251153 | NPI | - | NPPES |
1455783 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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