Organization
LAKESIDE HOME CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKINA LAKE (ADMINISTRATOR)
(813) 321-0440
Entity
Organization
Contact information
Practice address
4222 W GREEN ST, TAMPA, FL 33607-4102
(813) 321-0440
(813) 280-9151
Mailing address
4222 W GREEN ST, TAMPA, FL 33607-4102
(813) 321-0440
(813) 280-9151
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
234419
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
234419
HOMEMAKER & COMPAINION SERVICES
FL
Enumeration date
05/10/2016
Last updated
05/10/2016
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