| NPI | 1902981061 |
|---|---|
| Doing Business As | LAKESIDE LUTHERAN HOME |
| Entity Type | Organization |
| Authorized Contact | LARRY E PORATH President 712-852-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IA 740436) |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) (Licence: IA 740436) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2011-12-21 |