| Organization Name: | LAKE HOSPITAL SYSTEM, INC |
| NPI Number: | 1356675003 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT TRACZ (CFO) |
| Mailing Address: | 7590 Auburn Rd Concord Twp |
| State: | OH US |
| Postal Code: | 440779176 |
| Phone Number: | 4409539600 |
| Fax Number: | |
| NPI Enumeration Date: | 09/29/2009 |
| NPI Last Update Date: | 12/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0401X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Taxonomy Definition: | |