Organization
LAKE REGION HEALTHCARE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT MATTSON (CEO)
(218) 736-8090
Entity
Organization
Contact information
Practice address
712 S CASCADE ST, FERGUS FALLS, MN 56537-2913
(218) 736-8000
(218) 736-8775
Mailing address
712 S CASCADE ST, FERGUS FALLS, MN 56537-2913
(218) 736-8000
(218) 736-8775
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
327293
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1637ELA
BLUE CROSS
MN
01
—
1637HLA
BLUE CROSS
MN
05
—
316714300
—
MN
05
—
510847100
—
MN
05
—
510847101
—
MN
05
—
510847167
—
MN
01
—
60685LA
BLUE CROSS
MN
Enumeration date
07/12/2005
Last updated
08/19/2024
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