Lake Region Therapy Services Inc

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

9552335 Issued in MN

Legal business name

LAKE REGION THERAPY SERVICES INC

Practice address

803 Roosevelt Ave
Suite 301
Detroit Lakes, MN 56501-3744

Phone

(218) 844-5555

Fax

(218) 844-6057

NPI assigned

Jun 30, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jennifer Michelle Manning, OTR LNPI 1609099290

Title

Owner President

Phone

(218) 844-5555

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Michelle Manning, OTR/L, CHT

  • Occupational Therapist
  • Shiprock, NM
  • NPI 1609099290
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1154583292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 ROOSEVELT AVE",
            "address_2": "SUITE 301",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013744",
            "telephone_number": "218-844-5555",
            "fax_number": "218-844-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 ROOSEVELT AVE",
            "address_2": "SUITE 301",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013744",
            "telephone_number": "218-844-5555",
            "fax_number": "218-844-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE REGION THERAPY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "218-844-5555",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR L"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "MN",
            "license": "9552335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle L Kyllo Bouchie, PA-C
• Brian Labat, DDS
• Michael Keith Lachapelle, LADC
• Jennifer Ladd
• Carrie Amanda Lahr, APRN/CNP
• Lakeland Chiropractic Clinic
• Lakeridge Dental Partners, PLLC
• Lakes Country Healthcare P.L.L.C.
• Lakes Crisis & Resource Center
• Lakes Homes and Program Development, Inc.

• Rehabilitation Clinic/Center in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Rehabilitation Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.