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Organization

LAKESIDE BEIKIRCH CARE CENTER, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY KLINETOB (ADMINISTRATOR)
(585) 395-6095
Entity
Organization

Contact information

Practice address
170 WEST AVE, BROCKPORT, NY 14420-1227
(585) 395-6052
(585) 395-6007
Mailing address
170 WEST AVE, BROCKPORT, NY 14420-1227
(585) 395-6052
(585) 395-6007

Taxonomy

Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
2752301N
NY
314000000X
Skilled Nursing Facility
Primary
2752301N
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01137113
NY
01
106288CI
PREFERRED CARE
NY
01
CN
EXCELLUS
NY
Enumeration date
06/23/2005
Last updated
09/03/2015
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