| NPI | 1447733480 |
|---|---|
| Doing Business As | LAKESIDE HEALTH AND REHAB |
| Entity Type | Organization |
| Authorized Contact | BOYD WRIGHT COO 870-347-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2018-09-14 |