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General NPI Number Information
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NPI Number | 1396726873
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Entity Type | Organization
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Legal Business Name | LAKEVIEW NEUROREHAB CENTER MIDWEST, INC
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 1701 SHARP RD
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City | WATERFORD
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State | WI
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Zip | 53185-5214
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Country | US
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Telephone | 262-534-7297
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Fax | 262-534-7257
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Provider Business Mailing Address
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Address Line | 1701 SHARP RD
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City | WATERFORD
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State | WI
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Zip | 53185-5214
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Country | US
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Telephone | 262-534-7297
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Fax | 262-534-7257
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Authorized Official
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Title or Position | CEO
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Name | CHRISTOPHER SCOTT SLOVER
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Credential |
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Telephone | 511-773-8076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number |
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License Number State |
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