Organization
MAYBROOK-P LAKESIDE OPCO, LLC
Active
Other names
The Gardens at Lakeside
Organization subpart
No
Provider details
NPI number
Authorized official
EPHRAM M LAHASKY (MEMBER)
(646) 772-3668
Entity
Organization
Contact information
Practice address
245 OLD LAKE RD, DALLAS, PA 18612-3154
(570) 639-1885
Mailing address
34 LORD AVE, LAWRENCE, NY 11559-1324
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/10/2016
Last updated
11/15/2016
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