Lake Country Living Services LLC

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

LAKE COUNTRY LIVING SERVICES LLC

Doing business as

Lake Country Supported Living Services

Practice address

181 Little Rock Rd NW
Rice, MN 56367-8685

Phone

(218) 242-2498

NPI assigned

Oct 15, 2019

Last updated

Oct 15, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Natalie Burdick

Title

Owner, Ceo

Phone

(218) 242-2498

Specialties & licenses 1

Addresses

Other names 1

• Lake Country Supported Living Services Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1467094102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 LITTLE ROCK RD NW",
            "city": "RICE",
            "state": "MN",
            "postal_code": "563678685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 LITTLE ROCK RD NW",
            "city": "RICE",
            "state": "MN",
            "postal_code": "563678685",
            "telephone_number": "218-242-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTRY LIVING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "BURDICK",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "218-242-2498"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "natalie@lakecountrysls.com",
            "affiliation": "N",
            "endpointDescription": "Owner Email",
            "address_1": "181 Little Rock Rd NW",
            "city": "Rice",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563678685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lake Country Supported Living Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.