LAKE REGION LUTHERAN HOME, INC.
NPI 1619536976
Assisted Living Facility in Devils Lake, ND

Q: What is Lake Region Lutheran Home, Inc.'s NPI number?

The NPI number for Lake Region Lutheran Home, Inc. is 1619536976. It was assigned to this organization in the NPPES registry on June 11, 2019. The provider is doing business as Eventide Lake Country Manor Basic Care.

Q: What is Lake Region Lutheran Home, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since June 11, 2019

1332 10TH ST NE, DEVILS LAKE, ND 58301(701) 662-1880(701) 662-1084 Get Directions Write a Review

NPPES record last updated: June 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Lake Region Lutheran Home, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE REGION LUTHERAN HOME, INC. (NPI 1619536976), doing business as Eventide Lake Country Manor Basic Care, is a healthcare organization registered as an assisted living facility in Devils Lake, North Dakota and active in the NPI registry since June 2019. The organization lists Jon Riewer, President & Ceo, as its authorized official.

NPPES Registry Identity

NPI1619536976

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameLAKE REGION LUTHERAN HOME, INC.

Location Address1332 10TH ST NEDevils Lake, ND 58301-2329

Mailing Address801 Main Ave Ste 201Moorhead, MN 56560-2871 · (218) 291-2216

Phone(701) 662-1880

Fax(701) 662-1084

Organization SubpartNo

Authorized OfficialJon RiewerPresident & Ceo · (218) 291-2201

Enumeration DateJune 11, 2019

✔ NPI 1619536976 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

1332 10TH ST NE, Devils Lake, ND 58301

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Other Names 1

Doing Business AsEventide Lake Country Manor Basic Care

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Custodial Care Facility

1332 10TH ST NE
DEVILS LAKE, ND 58301

Ramsey County (701) 662-1800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Region Lutheran Home, Inc.'s NPI number?

The NPI number for Lake Region Lutheran Home, Inc. is 1619536976. It was assigned to this organization in the NPPES registry on June 11, 2019. The provider is doing business as Eventide Lake Country Manor Basic Care.

Where is Lake Region Lutheran Home, Inc. located?

Lake Region Lutheran Home, Inc. is located at 1332 10th St NE, Devils Lake, ND 58301. The listed phone number is (701) 662-1880.

What is Lake Region Lutheran Home, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Lake Region Lutheran Home, Inc. was last updated on June 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.