Organization
EASTSIDE OPERATING COMPANY LLC
Active
Other names
Lake Terrace Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN K. REYNOLDS (MANAGER)
(410) 513-8738
Entity
Organization
Contact information
Practice address
2115 E WOODSTOCK PL, MILWAUKEE, WI 53202-1342
(410) 342-3155
Mailing address
1423 CLARKVIEW RD, SUITE 500, BALTIMORE, MD 21209-2134
(410) 427-2700
(414) 815-5558
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
11/20/2009
Last updated
06/10/2015
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