Organization
MILLVILLE LEASING PARTNERSHIP
Active
Other names
Lakeside Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANCIS A HAYMAN JR. (PRESIDENT LEHIGH NURSING CORP)
(610) 264-8000
Entity
Organization
Contact information
Practice address
357 OLD LAKE RD, DALLAS, PA 18612
(570) 639-1885
(570) 639-5163
Mailing address
357 OLD LAKE RD, DALLAS, PA 18612
(570) 639-1885
(570) 639-5163
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
290902
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007557700003
—
PA
Enumeration date
10/13/2005
Last updated
11/11/2008
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