Organization
LAKE HEALTH DISTRICT
Active
Other names
Lakeview Home Health Care and Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLIE BODELL TVEIT (CEO)
(541) 947-2114
Entity
Organization
Contact information
Practice address
700 S J ST, LAKEVIEW, OR 97630-1623
(541) 947-2114
(541) 947-2433
Mailing address
700 S J ST, LAKEVIEW, OR 97630-1623
(541) 947-2114
(541) 947-2433
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
13140896
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107532
MEDICAID OREGON HEALTH
OR
01
—
802595
MEDICAID ORE.HEALTH L.T.C
OR
Enumeration date
01/25/2007
Last updated
01/21/2021
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