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General NPI Number Information
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NPI Number | 1932139441
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Entity Type | Organization
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Legal Business Name | LAKEVIEW HEALTHCARE, INC
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 1201 28TH AVE
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City | MERIDIAN
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State | MS
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Zip | 39301-3810
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Country | US
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Telephone | 601-483-1467
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Fax | 601-483-1483
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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 | PRESIDENT
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Name | MR. BRIAN K CAIN
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Credential |
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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 | 11731
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License Number State | MS
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