| Lake Region Therapeutic Services Inc | |
|
1007 Mainstreet Hopkins MN 55343-7517 | |
| (952) 456-6352 | |
| (952) 303-3104 |
| Full Name | Lake Region Therapeutic Services Inc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1007 Mainstreet, Hopkins, Minnesota |
| Authorized Official Name and Position | Abdirazaq Ibrahim (OWNER) |
| Authorized Official Contact | 6023234873 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Region Therapeutic Services Inc 3055 Old Highway 8 Ste 347 Saint Anthony MN 55418-2500 Ph: (952) 657-0884 | Lake Region Therapeutic Services Inc 1007 Mainstreet Hopkins MN 55343-7517 Ph: (952) 456-6352 |
| NPI Number | 1114484847 |
|---|---|
| Provider Enumeration Date | 02/28/2019 |
| Last Update Date | 09/13/2023 |
| Certification Date | 09/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114484847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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