# LAKEVIEW SUBACUTE CARE CENTER, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215057831
- **Authorized official:** MR. RICHARD FRANK GROSSO JR. LNHA (ADMINISTRATOR)
- **Authorized official phone:** (973) 616-5815

## Contact information

- **Practice address:** 130 TERHUNE DR, WAYNE, NJ 07470-7104
- **Practice address phone:** (973) 616-5815
- **Practice address fax:** (973) 616-2768
- **Mailing address:** 130 TERHUNE DR, WAYNE, NJ 07470-7104
- **Mailing address phone:** (973) 616-5815
- **Mailing address fax:** (973) 616-2768

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 61610 | NJ | Yes |

## Other

- **Enumeration date:** 03/29/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0047847 | AETNA USHC | — |
| 01 | — | 315110 | BLUE CROSS BLUE SHIELD | NJ |
| 05 | — | 4496205 | — | NJ |
| 01 | — | 4552 | AMERIHEALTH | — |
| 01 | — | 92624 | AMERIGROUP | — |
| 01 | — | ANC268 | OXFORD HEALTH | — |
| 01 | — | CV09616 | CIGNA | — |