Organization
LAKE WEST SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNN BROM (PRESIDENT)
(216) 731-3618
Entity
Organization
Contact information
Practice address
26300 EUCLID AVE, EUCLID, OH 44132-3703
(216) 731-3618
(216) 731-0411
Mailing address
26300 EUCLID AVE, EUCLID, OH 44132-3703
(216) 731-3618
(216) 731-0411
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128927
—
OH
Enumeration date
06/09/2006
Last updated
08/22/2020
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