Healthcare Provider Details

I. General information

NPI: 1174522239
Provider Name (Legal Business Name): LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5803 NEAL AVE N
OAK PARK HEIGHTS MN
55082-2177
US

IV. Provider business mailing address

8170 33RD AVENUE SOUTH MAILSTOP 21110Q
BLOOMINGTON MN
55425
US

V. Phone/Fax

Practice location:
  • Phone: 651-430-3320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA BJORKMAN
Title or Position: DIRECTOR
Credential:
Phone: 952-883-7469