| NPI | 1366431074 |
|---|---|
| Doing Business As | LAKESHORE CONV HOSPITAL |
| Entity Type | Organization |
| Authorized Contact | GAFFAR SYED Adminstrator 510-834-9880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CA ZZR05543I) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2020-08-22 |