Organization
LAKEVIEW HEALTH SYSTEMS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MOEN (CHIEF COMPLIANCE OFFICER)
(843) 687-4329
Entity
Organization
Contact information
Practice address
1900 CORPORATE SQUARE CT., JACKSONVILLE, FL 32216
(904) 727-6455
(904) 899-4514
Mailing address
1900 CORPORATE SQUARE BLVD, JACKSONVILLE, FL 32216-1941
(904) 513-5830
(866) 371-2833
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
0416AD076701
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8757
AHCA - RESIDENTIAL TREATMENT FACILITY LEVEL II EATING DISORDER TREATMENT
FL
Enumeration date
12/29/2006
Last updated
04/19/2023
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