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General NPI Number Information
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NPI Number | 1295015865
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Entity Type | Organization
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Legal Business Name | LAKEVIEW SENIOR CARE
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 801 E KIEHL AVE
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City | SHERWOOD
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State | AR
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Zip | 72120-3029
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Country | US
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Telephone | 501-835-4663
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Fax |
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Provider Business Mailing Address
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Address Line | 801 E KIEHL AVE
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City | SHERWOOD
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State | AR
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Zip | 72120-3029
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Country | US
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Telephone | 501-835-4663
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. SANDRA KAY MASTERS
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Credential |
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Telephone | 501-835-4663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 11128
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License Number State | AR
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