| NPI | 1972637171 |
|---|---|
| Doing Business As | LAKE PARK RESIDENTIAL CARE |
| Entity Type | Organization |
| Authorized Contact | ROBERT D KRUMWIED CEO 219-392-6010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: IN 06-001136-2) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |