Organization
LAKESIDE SKILLED CARE LLC
Active
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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