Provider Demographics
NPI:1962450171
Name:LAKELAND HOSPICE & HOME CARE, INC.
Entity Type:Organization
Organization Name:LAKELAND HOSPICE & HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:PELACCIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:701-388-8447
Mailing Address - Street 1:120 S UNION AVE
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2517
Mailing Address - Country:US
Mailing Address - Phone:218-736-7885
Mailing Address - Fax:218-736-2231
Practice Address - Street 1:120 S UNION AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2517
Practice Address - Country:US
Practice Address - Phone:218-736-7885
Practice Address - Fax:218-736-2231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3167143000Medicaid
MN247196Medicare ID - Type UnspecifiedHOME HEALTH NUMBER
MN3167143000Medicaid