| Preferred Residential Lifestyles | |
|
220 Milwaukee St Ste 2 Lakefield MN 56150-9495 | |
| (952) 563-2207 | |
| (952) 922-6885 |
| Full Name | Preferred Residential Lifestyles |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 220 Milwaukee St Ste 2, Lakefield, Minnesota |
| Authorized Official Name and Position | Brett Ian Cohen (COO) |
| Authorized Official Contact | 8003885150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Preferred Residential Lifestyles 6600 France Ave S Edina MN 55435-1805 Ph: (952) 922-6776 | Preferred Residential Lifestyles 220 Milwaukee St Ste 2 Lakefield MN 56150-9495 Ph: (952) 563-2207 |
| NPI Number | 1861903791 |
|---|---|
| Provider Enumeration Date | 10/18/2017 |
| Last Update Date | 03/04/2023 |
| Certification Date | 03/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861903791 | NPI | - | NPPES |
| 1071036-1-HCBS | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Minnesota) | Primary |