Organization
LAKESIDE SENIOR CARE LLC
Active
Other names
Lakeside Rehabilitation and Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
KERI POWELL (PRESIDENT)
(806) 793-2555
Entity
Organization
Contact information
Practice address
4306 24TH ST, LUBBOCK, TX 79410-1818
(806) 793-2555
Mailing address
930 RIDGEBROOK RD, SPARKS, MD 21152-9390
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/30/2009
Last updated
04/30/2009
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