LAKE REGION CORPORATION


Address: 2017 Highway 20, Devils Lake, ND 58301-8650
Phone: 7016628681

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 315P00000X Intermediate Care Facility, Mentally Retarded Nursing & Custodial Care Facilities

Other Provider IDs and Locations

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

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities LAKE REGION CORPORATION 224 3rd St Nw, Devils Lake, ND 58301-2908

Office Location

Street Address 2017 HIGHWAY 20
City DEVILS LAKE
State ND
Zip Code 58301-8650

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 315P00000X
Grouping Nursing & Custodial Care Facilities
Classification Intermediate Care Facility, Mentally Retarded

Taxonomy Definition

(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).

Providers in the same taxonomy and state

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
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Competitor

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City DEVILS LAKE
Zip Code 58301

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Dataset Information

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.

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