| NPI | 1548460231 |
|---|---|
| Doing Business As | LAKESIDE ASSISTED LIVING |
| Entity Type | Organization |
| Authorized Contact | ARLENE SPACK Executive Director 410-749-4480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MD 22AL019) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-07-20 |