| Lake Region Corporation | |
|
224 3rd St Nw Devils Lake ND 58301-2908 | |
| (701) 662-8681 | |
| Not Available |
| Full Name | Lake Region Corporation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 224 3rd St Nw, 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 224 3rd St Nw Devils Lake ND 58301-2908 Ph: (701) 662-8681 |
| NPI Number | 1740887702 |
|---|---|
| Provider Enumeration Date | 10/02/2020 |
| Last Update Date | 10/02/2020 |
| Certification Date | 10/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740887702 | NPI | - | NPPES |
| 1455784 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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