# SENIOR HEALTH-LAKESIDE, LLC

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

## Provider details

- **NPI number:** 1437156171
- **Authorized official:** SHANNON LYNN JANTZEN LNFA (ADMINISTRATOR)
- **Authorized official phone:** (806) 793-2555

## Contact information

- **Practice address:** 4306 24TH ST, LUBBOCK, TX 79410-1818
- **Practice address phone:** (806) 793-2555
- **Practice address fax:** (806) 793-9835
- **Mailing address:** 4306 24TH ST, LUBBOCK, TX 79410-1818
- **Mailing address phone:** (806) 793-2555
- **Mailing address fax:** (806) 793-9835

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 4622 | TX | Yes |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 08/30/2007