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NPI Code Detail

MEDICARE: LAKEVIEW NEUROREHAB CENTER MIDWEST, INC

MEDICARE: LAKEVIEW NEUROREHAB CENTER MIDWEST, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1323P00000XPsychiatric Residential Treatment Facility
2283X00000XRehabilitation Hospital
3282N00000XGeneral Acute Care Hospital
43416L0300XLand AmbulanceWI
5282E00000XLong Term Care Hospital

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396726873
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKEVIEW NEUROREHAB CENTER MIDWEST, INC
Provider Business Mailing Address
First Line : 1701 SHARP RD
Second Line :
City : WATERFORD
State : WI
Zip : 53185-5214
Country : US
Telephone Number : 262-534-7297
Fax Number : 262-534-7257
Provider Business Practice Location Address
First Line : 1701 SHARP RD
Second Line :
City : WATERFORD
State : WI
Zip : 53185-5214
Country : US
Telephone Number : 262-534-7297
Fax Number : 262-534-7257
Authorized Official
Title or Position : CEO
Name : CHRISTOPHER SCOTT SLOVER
Credential :
Telephone Number : 511-773-8076
Provider Enumeration Date : 11/10/2005
Last Update Date : 10/27/2025

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