Organization
LAKEWOOD SENIOR LIVING OF HAVILAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS KENT (EXECUTIVE VICE PRESIDENT)
(205) 320-7554
Entity
Organization
Contact information
Practice address
200 MAIN ST, HAVILAND, KS 67059-9525
(620) 862-5315
Mailing address
3008 7TH AVE S, BIRMINGHAM, AL 35233-3503
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
N049002
KS
Other
Enumeration date
11/15/2006
Last updated
08/22/2020
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