LAKESIDE SENIOR CARE LLC (NPI# 1902040223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902040223 |
| Entity Type | Organization |
| Organization Name | LAKESIDE SENIOR CARE LLC |
| Other Organization Name | LAKESIDE REHABILITATION AND CARE CENTER |
| Practice Address |
4306 24th St Lubbock TX 79410-1818 |
| Mailing Address |
930 Ridgebrook Rd Sparks MD 21152-9390 |
| Practice Telephone | 8067932555 |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |
| Authorized Official Name | KERI POWELL (PRESIDENT) |
| Authorized Official Telephone | 8067932555 |
| 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 Rehabilitation and Care Center | Doing Business As Name - Organization |
| Street Address |
4306 24TH ST |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79410-1818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437156171 | Senior Health-lakeside, LLC | Skilled Nursing Facility | 4306 24th St, Lubbock, TX 79410-1818 | 2005-07-07 |
| 1992902498 | Stratford Hospital District | Skilled Nursing Facility | 4306 24th St, Lubbock, TX 79410-1818 | 2007-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878267 | Covenant Medical Center | Clinic/Center | 3615 19th, Lifestyle Centre-east Parking Garage, Lubbock, TX 79410 | 2020-07-20 |
| 1669038626 | Hub City Anesthesia | Nurse Anesthetist, Certified Registered | 3416 22nd Street, Lubbock, TX 79410 | 2019-05-15 |
| 1912447418 | Lubbock Surgery Center, LLC | Clinic/Center | 3416 22nd St, Lubbock, TX 79410 | 2017-03-02 |
| 1871032698 | Lezlee Berry | Pharmacist | 3615 19th Street, Lubbock, TX 79410 | 2017-02-13 |
| 1376914101 | Matthew Cotton | Nurse Practitioner | 2424 Quaker Ave, Lubbock, TX 79410 | 2015-10-20 |
| 1841534864 | Frank Nwabugwu | Pharmacist | 4120 34th Street, Lubbock, TX 79410 | 2012-11-15 |
| 1689954794 | Dharmendra Kumar | Pediatrics | Covenant Children's Hospital, 4000 24th Street, Lubbock, TX 79410 | 2011-08-19 |
| 1518277177 | T.r.m. Rao, M.d., P.a. | Colon & Rectal Surgery | 3809 22nd Street, Suite C, Lubbock, TX 79410 | 2010-10-18 |
| 1700196672 | Hanford Consultations P.a. | Family Medicine | 4000 22nd Place Suite 100, Lubbock, TX 79410 | 2010-10-13 |
| 1336452598 | Amanda Collins | Specialist | 4801 34th Street, Lubbock, TX 79410 | 2010-07-16 |
| Find all providers in zip 79410 | ||||
| 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 |
|---|---|---|---|---|
| 1033589213 | Rehab Care | Skilled Nursing Facility | 1717 Norfork Ave, Bldg A, Lubbock, TX 79416 | 2015-10-01 |
| 1275921959 | Hansford County Hospital District | Skilled Nursing Facility | 4910 Emory St, Lubbock, TX 79416-3026 | 2015-01-02 |
| 1881945335 | Lubbock II Enterprises, LLC | Skilled Nursing Facility | 5502 W 4th St, Lubbock, TX 79416-4220 | 2012-09-24 |
| 1295020147 | Phcc-windmill Village Rehabilitation & Health Care Center, LLC | Skilled Nursing Facility | 507 Martin Luther King Blvd, Lubbock, TX 79403-5211 | 2011-06-17 |
| 1629372610 | J F Heritage LLC | Skilled Nursing Facility | 6640 Iola Ave, Lubbock, TX 79424-7845 | 2011-01-05 |
| 1003904376 | Thi of Texas At Lubbock II, LLC | Skilled Nursing Facility | 1401 9th Street, Lubbock, TX 79401 | 2006-10-11 |
| 1215977582 | Stratford Hospital District | Skilled Nursing Facility | 5301 University, Lubbock, TX 79413 | 2006-06-07 |
| 1063461994 | Hansford County Hospital District | Skilled Nursing Facility | 4910 Emory, Lubbock, TX 79416 | 2006-05-08 |
| 1659353589 | Stratford Hospital District | Skilled Nursing Facility | 4710 Slide Rd, Lubbock, TX 79414-3404 | 2005-11-16 |
| 1437156171 | Senior Health-lakeside, LLC | Skilled Nursing Facility | 4306 24th St, Lubbock, TX 79410-1818 | 2005-07-07 |
| Find all providers in LUBBOCK | ||||
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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.