Provider Demographics
NPI:1568514362
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:STEVEN
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 1:2301 HIGHWAY 71 SOUTH
Mailing Address - Street 2:PO BOX AB
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:712-336-8634
Practice Address - Street 1:2301 HIGHWAY 71 SOUTH
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360
Practice Address - Country:US
Practice Address - Phone:712-336-1230
Practice Address - Fax:712-336-8634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA300028H341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0091330Medicaid
MN0070HDIOtherBCMN PROVIDER NUMBER
IA60124OtherBCBS IA
MN0070HDIOtherBCMN PROVIDER NUMBER