Organization
LAKE REGION CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA SVEDBERG (CFO)
(701) 662-8681
Entity
Organization
Contact information
Practice address
224 3RD ST NW, DEVILS LAKE, ND 58301-2908
(701) 662-8681
Mailing address
224 3RD ST NW, DEVILS LAKE, ND 58301-2908
(701) 662-8681
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1455784
—
ND
Enumeration date
10/02/2020
Last updated
10/02/2020
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