Organization
LAKEVIEW BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS JOHNSON APRN, CNP (PRESIDENT)
(218) 302-4468
Entity
Organization
Contact information
Practice address
520 NW 1ST AVE STE 5, GRAND RAPIDS, MN 55744-2619
(218) 302-4468
(218) 302-1457
Mailing address
520 NW 1ST AVE STE 5, GRAND RAPIDS, MN 55744-2619
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
CNP 2950
MN
Other
Enumeration date
02/15/2016
Last updated
04/13/2016
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