Healthcare Provider Details
I. General information
NPI: 1770322356
Provider Name (Legal Business Name): LAKEVIEW REHABILITATION AND NURSING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2024
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1050 GRAND DR
BIGFORK MT
59911-3563
US
IV. Provider business mailing address
1050 GRAND DR
BIGFORK MT
59911-3563
US
V. Phone/Fax
- Phone: 385-498-0195
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MS.
WENDY
ANDERSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 801-360-8804