| NPI | 1801811609 |
|---|---|
| Former Legal Business Name | LAKEWOOD CONVALESCENT HOME, INC. |
| Entity Type | Organization |
| Authorized Contact | DEBORAH A TYLER Administrator 501-262-1920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AR 024) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2015-11-03 |