Provider Demographics
NPI:1710201520
Name:LAKES LIFESKILLS LLC
Entity Type:Organization
Organization Name:LAKES LIFESKILLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:SCHOFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-662-6655
Mailing Address - Street 1:PO BOX 431
Mailing Address - Street 2:1612 ITHACA
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360
Mailing Address - Country:US
Mailing Address - Phone:507-840-1364
Mailing Address - Fax:507-662-6655
Practice Address - Street 1:1612 ITHACA AVE
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1642
Practice Address - Country:US
Practice Address - Phone:507-840-1364
Practice Address - Fax:507-662-6655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health