MEDICARE: THE VILLAGES AT LAKESIDE, LLC

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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1780308627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE VILLAGES AT LAKESIDE, LLC

Provider Business Mailing Address
First Line	:	23700 COMMERCE PARK
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5827
Country	:	US
Telephone Number	:	216-292-5706
Fax Number	:

Provider Business Practice Location Address
First Line	:	13910 HUNTON LN
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-6088
Country	:	US
Telephone Number	:	704-897-2872
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLIAM WEISBERG
Credential	:
Telephone Number	:	216-292-5706

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	10/03/2022

Similar Medicare Providers

1831049949 — ASHLYN DAY
Practice Location Address:

13910 HUNTON LN
HUNTERSVILLE, NC
28078-6088

Practice Phone: 980-293-0819
Practice Fax:

1063091122 — CARSEN WEICHMAN
Practice Location Address:

13910 HUNTON LN
HUNTERSVILLE, NC
28078-6088

Practice Phone: 704-897-2872
Practice Fax:

1043584980 — COTREASE LAWSON
Practice Location Address:

16405 NORTHCROSS DR , STE G-2
HUNTERSVILLE, NC
28078-5091

Practice Phone: 704-439-3403
Practice Fax:

1841149382 — ALIGNED PSYCHIATRIC CARE, PLLC
Practice Location Address:

9121 PARK GROVE ST
HUNTERSVILLE, NC
28078-5517

Practice Phone: 630-518-2423
Practice Fax: 630-518-2423

1316897572 — IGNITE HUNTERSVILLE LLC
Practice Location Address:

12019 VERHOEFF DR
HUNTERSVILLE, NC
28078-9217

Practice Phone: 847-453-4000
Practice Fax:

1245424761 — TARA ANN KENNEDY FNP- BC
Practice Location Address:

14230 HUNTERS RD
HUNTERSVILLE, NC
28078-7335

Practice Phone: 704-316-6611
Practice Fax: 704-316-6612

Directions to “THE VILLAGES AT LAKESIDE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.