Provider Demographics
NPI:1427011402
Name:LAKES REGIONAL HEALTHCARE
Entity Type:Organization
Organization Name:LAKES REGIONAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-336-8796
Mailing Address - Street 1:PO BOX AB
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-0159
Mailing Address - Country:US
Mailing Address - Phone:712-336-1230
Mailing Address - Fax:712-336-8620
Practice Address - Street 1:2301 HIGHWAY 71
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1184
Practice Address - Country:US
Practice Address - Phone:712-336-1230
Practice Address - Fax:712-336-8620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA300028H275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA16U124Medicare Oscar/Certification