MEDICARE: LAKELAND HOME HEALTHCARE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	163WH0200X	Home Health Registered Nurse
2	208100000X	Physical Medicine & Rehabilitation Physician
3	225100000X	Physical Therapist
4	314000000X	Skilled Nursing Facility
5	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1881265171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKELAND HOME HEALTHCARE

Provider Business Mailing Address
First Line	:	1446 116TH ST
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-5569
Country	:	US
Telephone Number	:	715-239-2075
Fax Number	:	715-239-2116

Provider Business Practice Location Address
First Line	:	1446 116TH ST
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-5569
Country	:	US
Telephone Number	:	715-239-2075
Fax Number	:	715-239-2116

Authorized Official
Title or Position	:	CFO/CO-OWNER
Name	:	JOSEPH BORTON
Credential	:
Telephone Number	:	715-239-2075

Provider Enumeration Date	:	07/07/2021
Last Update Date	:	08/07/2024

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Directions to “LAKELAND HOME HEALTHCARE ” Practice Location

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