Organization
LAKES HOMES AND PROGRAM DEVELOPMENT, INC.
Active
Other names
West Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS R REIFFENBERGER (EXECUTIVE ADMINISTRATOR)
(218) 847-2785
Entity
Organization
Contact information
Practice address
1118 WEST AVE, DETROIT LAKES, MN 56501-3210
(218) 847-5642
(218) 847-7176
Mailing address
PO BOX 1355, DETROIT LAKES, MN 56502-1355
(218) 847-5642
(218) 847-7176
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
338509
MN
Other
Enumeration date
01/25/2008
Last updated
01/25/2008
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