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Organization
EASTSIDE OPERATING COMPANY LLC
Active
Organization
EASTSIDE OPERATING COMPANY LLC
Active
Other names
Lake Terrace Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN K. REYNOLDS (MANAGER)
(410) 513-8738
Entity
Organization
Contact information
Practice address
2115 E WOODSTOCK PL, MILWAUKEE, WI 53202-1342
(410) 342-3155
Mailing address
1423 CLARKVIEW RD, SUITE 500, BALTIMORE, MD 21209-2134
(410) 427-2700
(414) 815-5558
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
11/20/2009
Last updated
06/10/2015
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