| NPI | 1679973465 |
|---|---|
| Doing Business As | LAKESIDE MANOR |
| Entity Type | Organization |
| Authorized Contact | DANIEL LLOYD BAILEY President 619-561-8626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311500000X Alzheimer Center (Dementia Center) (Licence: CA 374600038) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: CA 374600038) |
| 315D00000X Hospice, Inpatient (Licence: CA 374600038) | |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2014-08-28 |