| NPI | 1609997279 |
|---|---|
| Doing Business As | LAKE SHORE VILLAGE HEALTHCARE CENTER |
| Entity Type | Organization |
| Authorized Contact | CLARK SANDERSON Board President 903-583-1854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 118078) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2022-09-21 |