Organization
LAKE HEALTH DISTRICT
Active
Other names
Lakeview Home Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON ENSLEY (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
251E00000X
Home Health Agency
Primary
13140896
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107532
MEDICAID OREGON HEALTH
OR
01
—
802595
MEDICAID ORE.HEALTHL.T.C.
OR
Enumeration date
01/25/2007
Last updated
04/03/2008
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