LAKES OPIOID TREATMENT PROGRAM, INC (NPI# 1104374073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104374073 |
| Entity Type | Organization |
| Organization Name | LAKES OPIOID TREATMENT PROGRAM, INC |
| Practice Address |
8381 Lake Land Trl Nw Walker MN 56484-2109 |
| Mailing Address |
15477 Sodium St Nw Ramsey MN 55303-5415 |
| Practice Telephone | 7634129441 |
| Mailing Telephone | 7634129441 |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2016-10-10 |
| Authorized Official Name | STEPHANIE DAWN LOSH (CO-OWNER) |
| Authorized Official Telephone | 6128772465 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
8381 LAKE LAND TRL NW |
| City | WALKER |
| State | MN |
| Zip Code | 56484-2109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265058259 | Janna Wiele | Social Worker | 301 4th St S, Walker, MN 56484 | 2020-06-25 |
| 1649831264 | Alyssa Sharon Robley | Physical Therapist | 106 Fifth St S, Walker, MN 56484 | 2019-06-25 |
| 1447733639 | Walker Adult Day Services | Clinic/Center | 6835 Cranberry Bog Trl Nw, Walker, MN 56484 | 2018-09-13 |
| 1750827234 | Walker Operations LLC | Skilled Nursing Facility | 209 Birchwood Avenue West, Walker, MN 56484 | 2017-01-09 |
| 1699178707 | David Farder | Physical Therapist | 106 5th St S, Walker, MN 56484 | 2014-10-02 |
| 1083053292 | Gary F Wehrwein | Pharmacist | 1523 Suzanne Drive Ne, Longville, MN 56484 | 2013-06-20 |
| 1306141882 | First Choice Therapy | Clinic/Center | 6068 E Ottertail Rd Nw, Walker, MN 56484 | 2011-01-14 |
| 1033421029 | Walker Wellness Chiropractic Center, Pa | Chiropractor | 215 Garden Street, Walker, MN 56484 | 2010-07-08 |
| 1538343496 | Walker Wellness Chiropractic | Chiropractor | 507 Front Street West, Walker, MN 56484 | 2007-12-27 |
| 1629263827 | Shingobee Island Lodge Incorporated | Community Based Residential Treatment Facility, Mental Illness | 7185 Dewdrop Trail Nw, Walker, MN 56484 | 2007-09-11 |
| Find all providers in zip 56484 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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|---|---|---|---|---|
| 1174022404 | Harmony Ridge Recovery Center, LLC | Clinic/Center | 47 Chambers Circle Drive, Walker, WV 26180 | 2018-02-01 |
| 1891215604 | White Oak Run, LLC | Clinic/Center | 47 Chambers Circle Rd, Walker, WV 26180-3585 | 2017-06-22 |
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| 1093340036 | Humble Recovery | Clinic/Center | 1156 Aldrich Ave N, Minneapolis, MN 55411-4248 | 2020-03-10 |
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| 1881250785 | Adap Consulting | Clinic/Center | 1605 Southcross Dr W Ste B, Burnsville, MN 55306-7013 | 2019-05-15 |
| 1821550005 | Coscarelli Consulting, LLC | Clinic/Center | 1687 Woodlane Dr Ste 2002, Woodbury, MN 55125-3063 | 2019-04-04 |
| 1669943908 | Capital Health Services LLC | Clinic/Center | 680 Mendelssohn Ave N, Golden Valley, MN 55427-4306 | 2018-12-16 |
| 1013497916 | Thrive Behavioral Network Iv, LLC | Clinic/Center | 119 Friberg Ave, Suite B, Fergus Falls, MN 56537-2251 | 2018-08-20 |
| 1780186130 | Alliance Wellness Clinic Inc. | Clinic/Center | 8040 Old Cedar Ave. S. Ste. 100, Bloomington, MN 55425-1211 | 2018-03-01 |
| 1447795596 | Conceptual Counseling & Assessment | Clinic/Center | 151 W Burnsville Pkwy Ste 101, Burnsville, MN 55337-2525 | 2016-12-28 |
| 1871035568 | No Other Way (now) Recovery Services LLC | Clinic/Center | 1614 W 3rd St, Red Wing, MN 55066-2086 | 2016-11-11 |
| 1285095778 | Wild River Services | Clinic/Center | 1246 University Ave W Ste 101, Saint Paul, MN 55104-4125 | 2016-03-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.