Organization
LAKE REGION LUTHERAN HOME, INC.
Active
Other names
Heartland Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARISSA OLSON LNHA (CEO)
(701) 662-4905
Entity
Organization
Contact information
Practice address
620 14TH AVE NE, DEVILS LAKE, ND 58301-2808
(701) 662-4905
(701) 662-9170
Mailing address
620 14TH AVE NE, DEVILS LAKE, ND 58301-2808
(701) 662-4905
(701) 662-9170
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
1013A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D30010
—
ND
Enumeration date
08/23/2005
Last updated
07/10/2014
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