Organization
SENIOR HEALTH-LAKESIDE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON LYNN JANTZEN LNFA (ADMINISTRATOR)
(806) 793-2555
Entity
Organization
Contact information
Practice address
4306 24TH ST, LUBBOCK, TX 79410-1818
(806) 793-2555
(806) 793-9835
Mailing address
4306 24TH ST, LUBBOCK, TX 79410-1818
(806) 793-2555
(806) 793-9835
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4622
TX
Other
Enumeration date
07/07/2005
Last updated
08/30/2007
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