RELIANT LAKESIDE HOLDINGS LLC (NPI# 1124385000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124385000 |
| Entity Type | Organization |
| Organization Name | RELIANT LAKESIDE HOLDINGS LLC |
| Other Organization Name | LAKESIDE HEALTH AND REHABILITATION CENTER |
| Practice Address |
Rr 4 Box 357 Dallas PA 18612-9236 |
| Mailing Address |
3601 Island Ave Philadelphia PA 19153-3228 |
| Practice Telephone | 5706391885 |
| Mailing Telephone | 2155583700 |
| Mailing Fax Number | 2155583701 |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2012-04-18 |
| Authorized Official Name | MARC MYZAL (COO) |
| Authorized Official Telephone | 2155583700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Lakeside Health and Rehabilitation Center | Doing Business As Name - Organization |
| Street Address |
RR 4 BOX 357 |
| City | DALLAS |
| State | PA |
| Zip Code | 18612-9236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487009882 | Jacqueline Patricia O'brien | Occupational Therapist | 345 Lake Louise Rd, Dallas, PA 18612 | 2016-05-04 |
| 1164772927 | Katie M Ferguson | Pharmacist | 26 Dallas Shopping Center Memorial Highway, Dallas, PA 18612 | 2012-09-19 |
| 1619235892 | Crista Zern | Physical Therapist | 4 East Center Hill Road, Dallas, PA 18612 | 2012-04-25 |
| 1336423631 | Angela Mary Evans | Nurse Practitioner | 301 Lake Street, Misericordia University's Health & Wellness Center, Dallas, PA 18612 | 2011-10-05 |
| 1376835868 | Peter Frederick Casterline | Surgery | 5 Old Well Lane, Dallas, PA 18612 | 2011-05-03 |
| 1336386051 | Judy A Williams | Speech-Language Pathologist | 368 Tioga Avenue, Kingston, PA 18612 | 2009-01-16 |
| 1013195015 | Joseph John Kowalski | Psychiatry & Neurology | 2 Birch Hill Lane, Dallas, PA 18612 | 2008-02-01 |
| 1063621233 | Back Mountain Pediatrics | Clinical Medical Laboratory | 550 Memorial Highway, Dallas, PA 18612 | 2007-05-22 |
| 1760699177 | Leonard M Evans | Internal Medicine | 1806 Country Club Apartments, Dallas, PA 18612 | 2007-05-16 |
| 1417170549 | Clem-mar House, Inc. | Substance Abuse Rehabilitation Facility | 2860 State Route 309, Dallas, PA 18612 | 2007-04-10 |
| Find all providers in zip 18612 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073136149 | Continuum Rehab Group | Skilled Nursing Facility | 3326 Burgoyne St # 1432, Dallas, TX 75233-1304 | 2020-05-24 |
| 1013546118 | The Legacy Midtown Park, Inc | Skilled Nursing Facility | 8280 Manderville Lane, Dallas, TX 75231 | 2020-04-02 |
| 1508325275 | Buckner Senior Living, Inc. | Skilled Nursing Facility | One Ventana Way, 8301 N Central Expressway, Dallas, TX 75225 | 2019-03-13 |
| 1437625092 | Le Reve Rehab & Mc LLC | Skilled Nursing Facility | 3309 Dilido Road, Dallas, TX 75228 | 2018-10-22 |
| 1740710094 | Adora 9 Operations, LLC | Skilled Nursing Facility | 8130 Meadow Road, Dallas, TX 75231 | 2017-06-19 |
| 1962891523 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 3505 S Buckner Blvd Bldg 5, Dallas, TX 75227-5451 | 2015-01-20 |
| 1346678398 | The Rehabilitation & Wellness Centre of Dallas, LLC | Skilled Nursing Facility | 4200 Live Oak St, Dallas, TX 75204-6733 | 2013-10-29 |
| 1639428972 | Riverwood Healthcare LLC | Skilled Nursing Facility | 9009 Forest Lane, Dallas, TX 75243 | 2012-08-31 |
| 1013265446 | Remarkable Healthcare of Dallas, Lp | Skilled Nursing Facility | 3350 Bonnie View Road, Dallas, TX 75216 | 2012-08-15 |
| 1558620633 | Highland Springs, Inc | Skilled Nursing Facility | 7910 Frankford Rd, Attn: Extended Care Administrator, Dallas, TX 75252-6865 | 2012-05-10 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.