Provider Demographics
NPI:1902994866
Name:THE LAKES REGION MENTAL HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:THE LAKES REGION MENTAL HEALTH CENTER, INC.
Other - Org Name:GENESIS BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR REVENUE CYCLE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:FERREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-524-1100
Mailing Address - Street 1:40 BEACON ST E
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-3437
Mailing Address - Country:US
Mailing Address - Phone:603-524-1100
Mailing Address - Fax:
Practice Address - Street 1:40 BEACON ST E
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3437
Practice Address - Country:US
Practice Address - Phone:603-524-1100
Practice Address - Fax:603-527-8113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHLAKE663566OtherANTHEM
NH3076838Medicaid
NHNH3566Medicare ID - Type UnspecifiedMEDICARE