| Lakeview Behavioral Health Llc | |
|
520 Nw 1st Ave Ste 5 Grand Rapids MN 55744-2619 | |
| (218) 302-4468 | |
| (218) 302-1457 |
| Full Name | Lakeview Behavioral Health Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 520 Nw 1st Ave Ste 5, Grand Rapids, Minnesota |
| Authorized Official Name and Position | Thomas Johnson (PRESIDENT) |
| Authorized Official Contact | 2183024468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeview Behavioral Health Llc 520 Nw 1st Ave Ste 5 Grand Rapids MN 55744-2619 Ph: () - | Lakeview Behavioral Health Llc 520 Nw 1st Ave Ste 5 Grand Rapids MN 55744-2619 Ph: (218) 302-4468 |
| NPI Number | 1164881561 |
|---|---|
| Provider Enumeration Date | 02/15/2016 |
| Last Update Date | 04/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164881561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | CNP 2950 (Minnesota) | Primary |
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