Healthcare Provider Details

I. General information

NPI: 1821916552
Provider Name (Legal Business Name): LAKEVIEW SNF OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 WOODLAND AVE
EUFAULA OK
74432-3611
US

IV. Provider business mailing address

607 WOODLAND AVE
EUFAULA OK
74432-3611
US

V. Phone/Fax

Practice location:
  • Phone: 918-618-9588
  • Fax: 405-252-5632
Mailing address:
  • Phone: 918-618-9588
  • Fax: 405-252-5632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ETHAN DREIFUS
Title or Position: MANAGER
Credential:
Phone: 917-207-2234