# LAKESIDE HOME CARE SERVICES

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

## Provider details

- **NPI number:** 1326494105
- **Authorized official:** LAKINA LAKE (ADMINISTRATOR)
- **Authorized official phone:** (813) 321-0440

## Contact information

- **Practice address:** 4222 W GREEN ST, TAMPA, FL 33607-4102
- **Practice address phone:** (813) 321-0440
- **Practice address fax:** (813) 280-9151
- **Mailing address:** 4222 W GREEN ST, TAMPA, FL 33607-4102
- **Mailing address phone:** (813) 321-0440
- **Mailing address fax:** (813) 280-9151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 234419 | FL | Yes |

## Other

- **Enumeration date:** 05/10/2016
- **Last updated:** 05/10/2016