MEDICARE: LAKEVIEW HOME CARE 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
1	251E00000X	Home Health Agency	003523	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1780775668
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKEVIEW HOME CARE INC

Provider Business Mailing Address
First Line	:	307 EAST SAN PATRICIO
Second Line	:
City	:	MATHIS
State	:	TX
Zip	:	78368
Country	:	US
Telephone Number	:	361-547-5501
Fax Number	:	361-547-3688

Provider Business Practice Location Address
First Line	:	307 EAST SAN PATRICIO
Second Line	:
City	:	MATHIS
State	:	TX
Zip	:	78368
Country	:	US
Telephone Number	:	361-547-5501
Fax Number	:	361-547-3688

Authorized Official
Title or Position	:	OWNER / ADMINISTRATOR / CEO
Name	:	MS. MARTA A. BUENTELLO
Credential	:
Telephone Number	:	361-547-5501

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	03/24/2016

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Directions to “LAKEVIEW HOME CARE INC ” Practice Location

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