Organization
LAKEVIEW RANCH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY A BERRY (CEO)
(320) 275-4027
Entity
Organization
Contact information
Practice address
69531 213TH ST, DARWIN, MN 55324-6602
(320) 275-4027
(320) 275-4028
Mailing address
69531 213TH ST, DARWIN, MN 55324-6602
(320) 275-4027
(320) 275-4028
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
FBL001772920487
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0566381
—
MN
Enumeration date
10/17/2006
Last updated
08/22/2020
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