| Organization Name: | LAKESIDE COMPREHENSIVE REHABILITATION INC. |
| NPI Number: | 1396779542 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH WINDELL (OWNER/O.T.R.L) |
| Mailing Address: | 601 E Main St Hart |
| State: | MI US |
| Postal Code: | 494201144 |
| Phone Number: | 2318733577 |
| Fax Number: | 2318733557 |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 03/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |