Organization
LAKE REGION LUTHERAN HOME, INC.
Active
Other names
Eventide Lake Country Manor Basic Care
Organization subpart
No
Provider details
NPI number
Authorized official
JON RIEWER (PRESIDENT & CEO)
(218) 291-2201
Entity
Organization
Contact information
Practice address
1332 10TH ST NE, DEVILS LAKE, ND 58301-2329
(701) 662-1880
(701) 662-1084
Mailing address
801 MAIN AVE STE 201, MOORHEAD, MN 56560-2871
(218) 291-2216
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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