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Organization
LAKE HEALTH DISTRICT
Active
Organization
LAKE HEALTH DISTRICT
Active
Other names
Lakeview Home Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON ENSLEY (CEO)
(541) 947-2114
Entity
Organization
Contact information
Practice address
700 S J ST, LAKEVIEW, OR 97630-1623
(541) 947-2114
(541) 947-2433
Mailing address
700 S J ST, LAKEVIEW, OR 97630-1623
(541) 947-2114
(541) 947-2433
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
13140896
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107532
MEDICAID OREGON HEALTH
OR
01
—
802595
MEDICAID ORE.HEALTHL.T.C.
OR
Enumeration date
01/25/2007
Last updated
04/03/2008
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