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Organization
SUTTER LAKESIDE HOME MEDICAL SERVICES
Active
Organization
SUTTER LAKESIDE HOME MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FAITH D LYKKEN BSN, RN (DIRECTOR /ADMINISTRATOR)
(707) 263-7400
Entity
Organization
Contact information
Practice address
843 PARALLEL DR, LAKEPORT, CA 95453-5707
(707) 263-7400
(707) 263-1964
Mailing address
843 PARALLEL DR, LAKEPORT, CA 95453-5707
(707) 263-7400
(707) 263-1964
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
010000118
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07620G
—
CA
Enumeration date
01/26/2006
Last updated
01/13/2009
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