| Organization Name: | LAKESHORE CAP, INC. |
| NPI Number: | 1396183372 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL VETTE HUCK (CEO) |
| Mailing Address: | 702 State St Manitowoc |
| State: | WI US |
| Postal Code: | 542204034 |
| Phone Number: | 9206823737 |
| Fax Number: | 9206868700 |
| NPI Enumeration Date: | 06/12/2013 |
| NPI Last Update Date: | 06/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |