Healthcare Provider Details

I. General information

NPI: 1669800132
Provider Name (Legal Business Name): LAKEWINDS HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2013
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5003 WESTLUND RD
SAGINAW MN
55779-9783
US

IV. Provider business mailing address

5003 WESTLUND RD
SAGINAW MN
55779-9783
US

V. Phone/Fax

Practice location:
  • Phone: 218-348-0164
  • Fax: 218-729-1723
Mailing address:
  • Phone: 218-348-0164
  • Fax: 218-729-1723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA BREKKE
Title or Position: OWNER
Credential:
Phone: 218-348-0164