- Enrollment id
- O20070221000308
- Enrollment state
- IA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1932163904
- Multiple npi flag
- N
- Ccn
- 167106
- Associate id
- 0941118442
- Organization name
- LAKES REGIONAL HEALTHCARE
- Doing business as name
- LAKES REGIONAL HEALTHCARE HOME CARE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 2301 HIGHWAY 71
- City
- SPIRIT LAKE
- State
- IA
- Zip code
- 513601184