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Organization

LAKESIDE SKILLED CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FARAH MOHAMED MOHAMOUD (OWNER)
(701) 885-9006
Entity
Organization

Contact information

Practice address
6043 HUDSON RD STE 140S, WOODBURY, MN 55125-1030
(651) 500-5723
Mailing address
6043 HUDSON RD STE 140S, WOODBURY, MN 55125-1030

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
09/17/2025
Last updated
09/17/2025
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