LAKEWOOD ADULT FAMILY HOME INC (NPI# 1194920488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194920488 |
| Entity Type | Organization |
| Organization Name | LAKEWOOD ADULT FAMILY HOME INC |
| Practice Address |
69 Rainbows End Bomoseen VT 05732-4417 |
| Mailing Address |
Pob 1543 Castleton VT 05735-1543 |
| Practice Telephone | 8024683010 |
| Practice Fax Number | 8024685374 |
| Mailing Telephone | 8024683010 |
| Mailing Fax Number | 8024685374 |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2008-06-24 |
| Authorized Official Name | MR. RICHARD JAMES CHURCH (ADMINISTRATOR) |
| Authorized Official Telephone | 8024683010 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
544 | VT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 047W278 | 05 |
| Street Address |
69 RAINBOWS END |
| City | BOMOSEEN |
| State | VT |
| Zip Code | 05732-4417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457627390 | Jillian Iris Finker | General Practice | 55 North Route 30, Bomoseen, VT 05732 | 2012-03-26 |
| 1750599122 | Andrea R Hubbard Maclauchlan | Pharmacist | 34 Route 30n, Bomoseen, VT 05732 | 2007-05-18 |
| 1619049020 | The Coon House | Custodial Care Facility | 74 Route 30 S, Bomoseen, VT 05732 | 2006-11-14 |
| 1811071574 | Edward William Brown | Chiropractor | Route 30, Castleton Corners Professional Center, Bomoseen, VT 05732 | 2006-10-25 |
| 1942817937 | Hannah Mary Ojala | Pharmacist | 34 Route 30 North, Bomoseen, VT 05732 | 2020-09-24 |
| 1215174834 | Kph Healthcare Services, Inc. | Pharmacy | 34 Route 30 North, Bomoseen, VT 05732 | 2009-01-20 |
| 1255440327 | Harbor Pharmacy | Pharmacy | 34 Route 30 North, Bomoseen, VT 05732-0284 | 2006-08-30 |
| 1396748489 | Pauline Kahng | Physician Assistant | 275 Route 30 N, Bomoseen, VT 05732-9647 | 2005-05-23 |
| 1396115648 | Jayme Hughes | Nurse Practitioner | 275 Route 30 N, Bomoseen, VT 05732-9647 | 2015-09-30 |
| 1891196804 | Theresa Haywood | Nurse Practitioner | 275 Route 30 N, Bomoseen, VT 05732-9647 | 2014-09-09 |
| Find all providers in zip 05732 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619049020 | The Coon House | Custodial Care Facility | 74 Route 30 S, Bomoseen, VT 05732 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669929006 | Elcm Homestead Management LLC | Custodial Care Facility | 3 Harbor View Dr, Saint Albans, VT 05478-4477 | 2016-09-01 |
| 1518365485 | Bradford Oasis | Custodial Care Facility | 92 Cottage St, Bradford, VT 05033-8897 | 2014-12-09 |
| 1457573545 | The Squier House, Inc. | Custodial Care Facility | 26 Union Street, Waterbury, VT 05676-0000 | 2007-05-02 |
| 1114142825 | Roxanne Hanson Ladabouche | Custodial Care Facility | 34 Canada St, Swanton, VT 05488-1041 | 2007-04-16 |
| 1538282140 | Sharon Sylvester | Custodial Care Facility | 70 Birch St, Bradford, VT 05033-9027 | 2007-04-09 |
| 1437272085 | Clarks Residential Care Home LLC | Custodial Care Facility | 213 Clark Rd, Hyde Park, VT 05655-9218 | 2007-04-09 |
| 1700905627 | The King's Daughters Home, Inc. | Custodial Care Facility | 10 Rugg St, Saint Albans, VT 05478-1713 | 2007-03-29 |
| 1528185360 | Craftsbury Community Care Center, Inc. | Custodial Care Facility | 1784 E Craftsbury Rd, Craftsbury, VT 05826-9519 | 2007-03-26 |
| 1154446367 | Windover House Inc | Custodial Care Facility | 451 Vt Route 66, Randolph, VT 05060-9387 | 2007-03-20 |
| 1508997487 | Mayo Healthcare Inc | Custodial Care Facility | 610 Water St, Northfield, VT 05663-5640 | 2007-03-09 |
| Find all providers with the same taxonomy | ||||
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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.