| NPI | 1386005502 |
|---|---|
| Former Legal Business Name | LAKE HEALTH SERVICES |
| Entity Type | Organization |
| Authorized Contact | LOLOCHINYERE FIDELIA NNAJIOFOR Director And Program COO Rdinator 956-570-1763 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine |
| 251B00000X Case Management | |
| 302R00000X Health Maintenance Organization | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2018-01-05 |