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General NPI Number Information
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NPI Number | 1720081052
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Entity Type | Organization
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Legal Business Name | LAKEVIEW CORPORATION
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 16411 ROBINSON RD
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City | GULFPORT
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State | MS
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Zip | 39503-4879
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Country | US
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Telephone | 228-831-3001
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Fax | 228-831-0408
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Provider Business Mailing Address
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Address Line | 16411 ROBINSON RD
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City | GULFPORT
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State | MS
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Zip | 39503-4879
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Country | US
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Telephone | 228-831-3001
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Fax | 228-831-0408
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. DIANE CARPENTER
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Credential | LNHA
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Telephone | 228-831-3001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 735
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License Number State | MS
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