Organization
LAKEVILLE RELIEF CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WARIS ABDI NP (SUPERVISOR)
(619) 855-7078
Entity
Organization
Contact information
Practice address
5661 162ND ST W, LAKEVILLE, MN 55044-2271
(619) 855-7078
Mailing address
5661 162ND ST W, LAKEVILLE, MN 55044-2271
(619) 855-7078
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A497491900
MHCP UMPI
MN
Enumeration date
07/10/2025
Last updated
07/10/2025
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