Provider Demographics
NPI:1972566875
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 1:1003 21ST STREET
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:IA
Mailing Address - Zip Code:51351
Mailing Address - Country:US
Mailing Address - Phone:712-338-9998
Mailing Address - Fax:712-338-9990
Practice Address - Street 1:1003 21ST STREET
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:IA
Practice Address - Zip Code:51351
Practice Address - Country:US
Practice Address - Phone:712-338-9998
Practice Address - Fax:712-338-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA300028H251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0615666Medicaid
IA161562Medicare Oscar/Certification