LAKE REGION CORPORATION (NPI# 1790302420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790302420 |
Entity Type | Organization |
Organization Name | LAKE REGION CORPORATION |
Practice Address |
2017 Highway 20 Devils Lake ND 58301-8650 |
Mailing Address |
224 3rd St Nw Devils Lake ND 58301-2908 |
Practice Telephone | 7016628681 |
Mailing Telephone | 7016628681 |
Enumeration Date | 2020-06-29 |
Last Update Date | 2020-06-29 |
Authorized Official Name | SANDRA SVEDBERG (CFO) |
Authorized Official Telephone | 7016628681 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487251153 | Lake Region Corporation | Community/Behavioral Health | 116 20th St Ne, Devils Lake, ND 58301-1616 | 2020-10-06 |
1740887702 | Lake Region Corporation | Community/Behavioral Health | 224 3rd St Nw, Devils Lake, ND 58301-2908 | 2020-10-02 |
1871659797 | Lake Region Corporation | Intermediate Care Facility, Mental Illness | 923 6th Ave Ne, Devils Lake, ND 58301-2210 | 2006-12-28 |
1689271355 | Lake Region Corporation | Community/Behavioral Health | 224 3rd St Nw, Devils Lake, ND 58301-2908 | 2020-10-06 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | LAKE REGION CORPORATION | 224 3rd St Nw, Devils Lake, ND 58301-2908 |
Street Address |
2017 HIGHWAY 20 |
City | DEVILS LAKE |
State | ND |
Zip Code | 58301-8650 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578187977 | Mark Christian Beatty | Social Worker | 1820 East Walnut Street, Suite 5, Devils Lake, ND 58301 | 2020-06-01 |
1841837663 | Wayne Rance | Pharmacist | 323 5th St Ne Ste 2, Devils Lake, ND 58301 | 2019-12-01 |
1639427792 | Donna Rance | Pharmacist | Bell Pharmacy 323 5th St Ne, Suite #2, Devils Lake, ND 58301 | 2012-08-21 |
1356603997 | Stephanie Ann Foughty | Family Medicine | 1001 7th St Ne Altru Clinic/devlis Lake, Devils Lake, ND 58301 | 2012-06-11 |
1245534668 | Altru Specialty Services, Inc. | Durable Medical Equipment & Medical Supplies | 223 4th Avenue Northeast, Suite B, Devils Lake, ND 58301 | 2010-12-28 |
1780830208 | Steven L Pederson | Physical Therapist | 404 Fourth Street N, Devils Lake, ND 58301 | 2008-08-15 |
1437368768 | Leatha N Vaagen | Physical Therapist | 404 Fourth Street North, Devils Lake, ND 58301 | 2007-05-22 |
1770634479 | Becky Fletschock | Pharmacist | Clinic Pharmacy, 1001 7th St Ne, Devils Lake, ND 58301 | 2007-01-16 |
1518047570 | The Evangelical Lutheran Good Samaritan Society | Custodial Care Facility | 302 7th Ave, Devils Lake, ND 58301 | 2006-10-16 |
1679591929 | Emergency Ambulance of Devils Lake | Ambulance | 314 2nd Ave Se, Devils Lake, ND 58301 | 2006-07-17 |
Find all providers in zip 58301 |
Taxonomy Code | 315P00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Intermediate Care Facility, Mentally Retarded |
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
1689197493 | Rem North Dakota | Intermediate Care Facility, Mentally Retarded | 1905 2nd Street Se, Suite 1a, Minot, ND 58701 | 2017-07-24 |
1548782790 | 1150 Group Home | Intermediate Care Facility, Mentally Retarded | 1150 N. Collins Aveue, Mandan, ND 58554 | 2017-07-10 |
1437690609 | 1140 Grouphome | Intermediate Care Facility, Mentally Retarded | 1140 Collins Ave, Mandan, ND 58554 | 2017-03-20 |
1861810053 | Red River Human Services Foundation | Intermediate Care Facility, Mentally Retarded | 903 Mulberry Ln, West Fargo, ND 58078-5000 | 2014-04-03 |
1144582933 | Anne Carlsen Center | Intermediate Care Facility, Mentally Retarded | 701 3rd Steeet Nw, Jamestown, ND 58401 | 2012-06-08 |
1578835641 | Hit Inc. 1301 Grouphome | Intermediate Care Facility, Mentally Retarded | 1301 7th Ave Se, Mandan, ND 58554 | 2012-02-03 |
1598062143 | 1201 Grouphome | Intermediate Care Facility, Mentally Retarded | 1201 7th Ave Se, Mandan, ND 58554 | 2011-02-17 |
1407153059 | 1203 Grouphome | Intermediate Care Facility, Mentally Retarded | 1203 7th Ave Se, Mandan, ND 58554 | 2011-02-17 |
1417124462 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 2424 18th St S, Fargo, ND 58103-5110 | 2008-05-09 |
Find all providers with the same taxonomy |
City | DEVILS LAKE |
Zip Code | 58301 |
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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.