MEDICARE: LAKES REGIONAL HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1558904417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKES REGIONAL HEALTHCARE

Provider Business Mailing Address
First Line	:	2408 ZENITH AVENUE
Second Line	:	SUITE E
City	:	SPIRIT LAKE
State	:	IA
Zip	:	51360
Country	:	US
Telephone Number	:	712-336-8796
Fax Number	:

Provider Business Practice Location Address
First Line	:	2408 ZENITH AVENUE
Second Line	:	SUITE E
City	:	SPIRIT LAKE
State	:	IA
Zip	:	51360
Country	:	US
Telephone Number	:	712-336-8796
Fax Number	:

Authorized Official
Title or Position	:	SR VP AND CFO
Name	:	STEVE ALGER
Credential	:
Telephone Number	:	712-336-8796

Provider Enumeration Date	:	10/23/2019
Last Update Date	:	08/06/2024

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Directions to “LAKES REGIONAL HEALTHCARE ” Practice Location

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