Individual
MR. LEWIS L LESTER IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPA
Contact information
Practice address
120 GRANT AVE, EVELETH, MN 55734-1520
(218) 410-5218
Mailing address
PO BOX 589, EVELETH, MN 55734-0589
(218) 410-5218
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251300000X
Local Education Agency (LEA)
—
CA
251B00000X
Case Management Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
CA
385H00000X
Respite Care
—
CA
Other
Enumeration date
06/22/2022
Last updated
06/22/2022
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