LAKEWOOD HEALTH CARE CENTER, INC. (NPI# 1134514961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134514961 |
| Entity Type | Organization |
| Organization Name | LAKEWOOD HEALTH CARE CENTER, INC. |
| Other Organization Name | ENNISCOURT ASSISTED LIVING |
| Practice Address |
13323 Detroit Ave Lakewood OH 44107-2849 |
| Practice Telephone | 2162263858 |
| Practice Fax Number | 2162268344 |
| Mailing Telephone | 2162263858 |
| Mailing Fax Number | 2162268344 |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2019-06-26 |
| Authorized Official Name | MRS. PATRICE CAMPBELL (OWNER/PRESIDENT) |
| Authorized Official Telephone | 2162263858 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | Y |
| Parent Organization Name | LAKEWOOD HEALTH CARE CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 0506R | OH | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| EnnisCourt Assisted Living | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699771089 | Lakewood Health Care Center, Inc. | Assisted Living Facility | 13315 Detroit Ave, Lakewood, OH 44107-2849 | 2005-06-22 |
| Street Address |
13323 DETROIT AVE |
| City | LAKEWOOD |
| State | OH |
| Zip Code | 44107-2849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
| 1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
| 1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
| 1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
| 1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
| 1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
| 1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
| Find all providers in zip 44107 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881294825 | Tcal2 | Assisted Living Facility | 1069 S Teller St, Lakewood, CO 80226-4554 | 2020-10-29 |
| 1336749373 | Tcal2 | Assisted Living Facility | 6419 W Mexico Ave, Lakewood, CO 80232-7055 | 2020-10-29 |
| 1891338083 | The Rising Sun Senior Home At Belmar Inc. | Assisted Living Facility | 835 S. Flower St, Lakewood, CO 80226 | 2019-10-21 |
| 1972076958 | Deshano Care Centers LLC | Assisted Living Facility | 9232 W Texas Dr, Lakewood, CO 80232-5100 | 2019-01-02 |
| 1740762061 | Deshano Care Centers LLC | Assisted Living Facility | 1975 Owens Ct, Lakewood, CO 80215-2732 | 2018-09-04 |
| 1932681335 | Deshano Care Centers LLC | Assisted Living Facility | 3225 S Reed Ct, Lakewood, CO 80227-5216 | 2018-08-31 |
| 1619425881 | The Rising Sun Senior Home Inc. | Assisted Living Facility | 421 S Fenton St, Lakewood, CO 80226-3556 | 2016-09-16 |
| 1134592108 | Peris Mungai | Assisted Living Facility | 11922 Nyanza Rd Sw, Lakewood, WA 98499-1438 | 2015-11-12 |
| 1457736399 | Senior Housing Investors II, LLC | Assisted Living Facility | 10420 Gravelly Lake Dr Sw, Lakewood, WA 98499-5041 | 2015-07-21 |
| 1447634266 | Fs Leisure Park Tenant Trust | Assisted Living Facility | 1400 Route 70, Lakewood, NJ 08701-5949 | 2015-07-10 |
| Find all providers in LAKEWOOD | ||||
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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.