# LAKELAND VILLAGE NURSING FACILITY

> 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:** 1780734509
- **Authorized official:** MR. STEVEN EARL KELLEN LNHA (ASSISTANT SUPERINTENDENT)
- **Authorized official phone:** (509) 299-1989

## Contact information

- **Practice address:** S 2320 SALNAVE ROAD, MEDICAL LAKE, WA 99022-0200
- **Practice address phone:** (509) 299-1989
- **Practice address fax:** (509) 299-1070
- **Mailing address:** PO BOX 200, MEDICAL LAKE, WA 99022-0200
- **Mailing address phone:** (509) 299-1989
- **Mailing address fax:** (509) 299-1070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 00L020 | WA | Yes |

## Other

- **Enumeration date:** 01/12/2007
- **Last updated:** 06/20/2008