Organization
SUMMIT REENTRY LLC
Active
Other names
SR LAKEVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
ASAD HASSAN (OWNER)
(612) 600-4575
Entity
Organization
Contact information
Practice address
17780 LTEN CT N, LAKEVILLE, MN 55044
(952) 737-2130
Mailing address
17780 LTEN CT N, LAKEVILLE, MN 55044
(952) 737-2130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/26/2023
Last updated
03/17/2025
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