| NPI | 1780397661 |
|---|---|
| Doing Business As | LAKESIDE POST ACUTE |
| Entity Type | Organization |
| Authorized Contact | JOHN MITCHELL Secretary 385-988-3319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2024-08-23 |