| NPI | 1780676049 |
|---|---|
| Doing Business As | LAKESIDE LIVING CENTER |
| Entity Type | Organization |
| Authorized Contact | SCOTT J BELL CEO President 850-430-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 290) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2020-08-22 |