Organization
LAKE HEALTH DISTRICT
Active
Other names
Lake District Hospital and LongTerm Care
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
275N00000X
Medicare Defined Swing Bed Hospital Unit
38Z309
OR
282NC0060X
Critical Access Hospital
Primary
140896
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107532
MEDICAID/OREGON HEALTH
OR
Enumeration date
07/13/2005
Last updated
01/21/2021
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