Organization
LAKEWOOD HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHAR RAY FEICKERT (CEO)
(218) 634-2120
Entity
Organization
Contact information
Practice address
600 MAIN AVE S, BAUDETTE, MN 56623-2855
(218) 634-1795
(218) 634-3490
Mailing address
600 MAIN AVE S, BAUDETTE, MN 56623-2855
(218) 634-1795
(218) 634-3490
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
331634
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1535ATR
BLUE CROSS
MN
01
—
59-00243
MEDICA
MN
Enumeration date
07/06/2006
Last updated
08/22/2020
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