Organization Name: | LAKESIDE LUTHERAN HOME |
NPI Number: | 1902981061 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LARRY E PORATH (PRESIDENT) |
Mailing Address: | 301 N Lawler St Emmetsburg |
State: | IA US |
Postal Code: | 505361073 |
Phone Number: | 7128524060 |
Fax Number: | 7128529914 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 12/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 311500000X |
License Number: | 740436 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IA |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Alzheimer Center (Dementia Center) |
Taxonomy Specialization: | |
Taxonomy Definition: | A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer |