# LAKE COUNTRY HOME CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Country Home Care LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811513674
- **Authorized official:** MICAELA KOEHLER (OWNER/MANAGER)
- **Authorized official phone:** (218) 385-3422

## Contact information

- **Practice address:** 201 E CENTENNIAL 84 DR, NEW YORK MILLS, MN 56567-4331
- **Practice address phone:** (218) 385-3422
- **Practice address fax:** (218) 385-3506
- **Mailing address:** 201 E CENTENNIAL 84 DR, NEW YORK MILLS, MN 56567-4331
- **Mailing address phone:** (218) 385-3422
- **Mailing address fax:** (218) 385-3506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/17/2020
- **Last updated:** 07/20/2026