NPI | 1609997279 |
---|---|
Doing Business As | LAKESHORE VILLAGE NURSING AND REHABILITATION. |
Entity Type | Organization |
Authorized Contact | CLARK SANDERSON Board President 817-372-7224 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 118078) |
Enumeration Date | 2007-04-02 |
Last Update Date | 2025-06-15 |