Organization
LAKELAND VILLAGE NURSING FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN EARL KELLEN LNHA (ASSISTANT SUPERINTENDENT)
(509) 299-1989
Entity
Organization
Contact information
Practice address
S 2320 SALNAVE ROAD, MEDICAL LAKE, WA 99022-0200
(509) 299-1989
(509) 299-1070
Mailing address
PO BOX 200, MEDICAL LAKE, WA 99022-0200
(509) 299-1989
(509) 299-1070
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
00L020
WA
Other
Enumeration date
01/12/2007
Last updated
06/20/2008
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