Organization
LAKELAND HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAYDARUS IBRAHIM (AUTHORIZED AGENT/MANGER)
(763) 273-3046
Entity
Organization
Contact information
Practice address
11840 FOLEY BLVD NW, COON RAPIDS, MN 55448-2210
(763) 273-3046
Mailing address
11840 FOLEY BLVD NW, COON RAPIDS, MN 55448-2210
(763) 273-3046
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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