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General NPI Number Information
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NPI Number | 1700216777
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Entity Type | Organization
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Legal Business Name | LAKEVIEW HEALTH CARE SERVICES INC
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 11/12/2013
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Provider Practice Location Address
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Address Line | 1112 US HIGHWAY 41 SUITE 210
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City | SCHERERVILLE
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State | IN
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Zip | 46375-1361
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Country | US
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Telephone | 219-218-4440
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Fax |
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Provider Business Mailing Address
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Address Line | 3405 VIOLET LN
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City | DYER
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State | IN
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Zip | 46311-2796
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Country | US
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Telephone | 219-218-4440
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAM O'GONUWE
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Credential |
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Telephone | 219-218-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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