Organization
LIVING SERVICES FOUNDATION/ NEW LONDON LLC
Active
Other names
LAKE REGION HOME HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES LAINE (ADMINISTRATOR)
(320) 354-6057
Entity
Organization
Contact information
Practice address
102 GLEN OAKS DR, NEW LONDON, MN 56273
(320) 354-5858
(320) 354-2060
Mailing address
100 GLEN OAKS DR, NEW LONDON, MN 56273
(320) 354-6068
(320) 354-2060
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HFID - 02204
MN
310400000X
Assisted Living Facility
Primary
345647
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498454400
—
MN
Enumeration date
05/07/2007
Last updated
09/30/2010
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