Organization
LAKEVIEW LUTHERAN MANOR
Active
Parent organization
LUTHERAN SOCIAL SERVICES OF MICHIGAN
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUTHERAN SOCIAL SERVICES OF MICHIGAN
Authorized official
DAVID GOODRICH (ADMINISTRATOR)
(231) 775-0101
Entity
Organization
Contact information
Practice address
460 PEARL ST, CADILLAC, MI 49601-2620
(231) 775-0101
(231) 775-1390
Mailing address
460 PEARL ST, CADILLAC, MI 49601-2620
(231) 775-0101
(231) 775-1390
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
844020
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09537
BCBS
MI
05
—
1796149
—
MI
Enumeration date
08/23/2005
Last updated
02/20/2008
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