Healthcare Provider Details

I. General information

NPI: 1033813530
Provider Name (Legal Business Name): LAKEWOOD SENIOR LIVING-DRUMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 S OLD TURNPIKE RD
DRUMS PA
18222-1726
US

IV. Provider business mailing address

3008 7TH AVE S
BIRMINGHAM AL
35233-3503
US

V. Phone/Fax

Practice location:
  • Phone: 570-788-4178
  • Fax: 570-788-5906
Mailing address:
  • Phone: 205-837-5336
  • Fax: 205-320-7595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
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: RICHARD JAMES BROCKMAN
Title or Position: MANAGER
Credential:
Phone: 205-837-5336