| NPI | 1467094102 |
|---|---|
| Doing Business As | LAKE COUNTRY SUPPORTED LIVING SERVICES |
| Entity Type | Organization |
| Authorized Contact | NATALIE BURDICK Owner, CEO 218-242-2498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253J00000X Foster Care Agency |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2019-10-15 |