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Organization
LAKEVIEW HOMECARE LLC
Active
Organization
LAKEVIEW HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICODEMUS WUANTAI NAIMODU (ASSISTED LIVING DIRECTOR)
(612) 516-3999
Entity
Organization
Contact information
Practice address
3655 145TH AVE NW, ANDOVER, MN 55304-3114
(612) 516-3999
(612) 887-4376
Mailing address
204 144TH LN NW, ANDOVER, MN 55304-6277
(612) 516-3999
(612) 887-4376
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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