NPIMap

Organization Active NPI

Lake Region Halfway Homes, Inc.

  • Substance Abuse Rehabilitation Facility
  • Fergus Falls, MN
National Provider Identifier
1851455323
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
801334-2-CDT Issued in MN
Legal business name
LAKE REGION HALFWAY HOMES, INC.
Practice address
217 N Union Ave
Fergus Falls, MN 56537-2127
Phone
(218) 739-9084
Fax
(218) 739-0518
NPI assigned
Dec 20, 2006
Last updated
Sep 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Authorized official

Name
Ms. Sherri E. Clark, LADC
Title
Treatment Director
Phone
(218) 739-9084

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 801334-2-CDT MN Primary

Addresses

Primary practice location

217 N Union Ave
Fergus Falls, MN 56537-2127

Mailing address

217 N Union Ave
Fergus Falls, MN 56537-2127
Phone (218) 739-9084

Other identifiers 1

IdentifierTypeStateIssuer
726555700OtherMNMHCP PROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

217 N Union Ave
Fergus Falls, MN 56537
Phone (218) 739-9084

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1851455323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 N UNION AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372127",
            "telephone_number": "218-739-9084",
            "fax_number": "218-739-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 N UNION AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372127",
            "telephone_number": "218-739-9084",
            "fax_number": "218-739-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE REGION HALFWAY HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "TREATMENT DIRECTOR",
        "authorized_official_telephone_number": "218-739-9084",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "801334-2-CDT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHCP PROVIDER NUMBER",
            "identifier": "726555700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; 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.