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NPI Code Detail

MEDICARE: LAKE REGION HUMAN SERVICE CENTER

MEDICARE: LAKE REGION HUMAN SERVICE CENTER
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
1261QD1600XDevelopmental Disabilities Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124069331
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE REGION HUMAN SERVICE CENTER
Provider Business Mailing Address
First Line : 200 HWY 2 W
Second Line :
City : DEVILS LAKE
State : ND
Zip : 58301-3532
Country : US
Telephone Number : 701-665-2200
Fax Number : 701-665-2300
Provider Business Practice Location Address
First Line : 200 HIGHWAY 2 W
Second Line :
City : DEVILS LAKE
State : ND
Zip : 58301-3532
Country : US
Telephone Number : 701-665-2200
Fax Number : 701-665-2300
Authorized Official
Title or Position : ASSISTANT CFO - DHS
Name : DONNA AUKLAND
Credential :
Telephone Number : 701-328-4924
Provider Enumeration Date : 06/09/2006
Last Update Date : 12/10/2020

Similar Medicare Providers

1508797655 — SAMANTHA MORRIS
Practice Location Address:
200 HIGHWAY 2 W
DEVILS LAKE, ND
58301-3532
Practice Phone: 701-665-2200
Practice Fax:
1770137952 — MOLLY HAGEMEISTER
Practice Location Address:
200 HIGHWAY 2 W
DEVILS LAKE, ND
58301-3532
Practice Phone: 701-665-2200
Practice Fax:
1669411930 — LAKE REGION BEHAVIORAL HEALTH CLINIC
Practice Location Address:
200 HIGHWAY 2 W
DEVILS LAKE, ND
58301-3532
Practice Phone: 701-665-2200
Practice Fax: 701-665-2300
1578504643 — AMY M HULTGREN LICSW
Practice Location Address:
200 HIGHWAY 2 W
DEVILS LAKE, ND
58301-3532
Practice Phone: 701-665-2200
Practice Fax: 701-665-2300
1568403772 — JAMES R CLINKENBEARD MD
Practice Location Address:
200 HIGHWAY 2W
DEVILS LAKE, ND
58301-3532
Practice Phone: 701-665-2200
Practice Fax: 701-665-2300
1730120882 — DAVID P KUNA PH.D.
Practice Location Address:
200 HIGHWAY 2 W
DEVILS LAKE, ND
58301-3532
Practice Phone: 701-665-2200
Practice Fax: 701-665-2300

Directions to “LAKE REGION HUMAN SERVICE CENTER ” Practice Location

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