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General NPI Number Information
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NPI Number | 1801811609
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Entity Type | Organization
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Legal Business Name | LAKEWOOD HEALTHCARE, INC.
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 260 LAKEPARK DRIVE
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City | HOT SPRINGS
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State | AR
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Zip | 71901
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Country | US
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Telephone | 501-262-1920
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Fax | 501-262-5237
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Provider Business Mailing Address
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Address Line | 260 LAKEPARK DRIVE
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City | HOT SPRINGS
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State | AR
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Zip | 71901
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Country | US
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Telephone | 501-262-1920
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Fax | 501-262-5237
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEBORAH A TYLER
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Credential | LPN, LNHA
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Telephone | 501-262-1920
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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 | 024
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License Number State | AR
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