| Organization Name: | LAKESIDE HOSPICE INC. |
| NPI Number: | 1346244399 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BETH GREEN (EXECUTIVE DIRECTOR) |
| Mailing Address: | 4010 Masters Rd Pell City |
| State: | AL US |
| Postal Code: | 351287550 |
| Phone Number: | 2058841111 |
| Fax Number: | 2058841114 |
| NPI Enumeration Date: | 06/08/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 10266 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |