| NPI | 1427827922 |
|---|---|
| Doing Business As | SR LAKEVILLE |
| Entity Type | Organization |
| Authorized Contact | ASAD HASSAN Owner 612-600-4575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251E00000X Home Health | |
| Enumeration Date | 2023-12-26 |
| Last Update Date | 2025-03-17 |