Healthcare Provider Details

I. General information

NPI: 1003081829
Provider Name (Legal Business Name): LAKEVIEW COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 WHITE MOUNTAIN HWY
TAMWORTH NH
03886-4626
US

IV. Provider business mailing address

2011 RUTLAND DR
AUSTIN TX
78758-5421
US

V. Phone/Fax

Practice location:
  • Phone: 603-323-7434
  • Fax:
Mailing address:
  • Phone: 512-973-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL AGUILAR
Title or Position: ACCOUNTS RECEIVABLE MANAGER
Credential:
Phone: 512-973-9700