LAKEWOOD RESIDENTIAL CARE, LLC (NPI# 1194772814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194772814 |
| Entity Type | Organization |
| Organization Name | LAKEWOOD RESIDENTIAL CARE, LLC |
| Other Organization Name | LAKEWOOD ASSISTED LIVING |
| Practice Address |
4685 S Robberson Ave Springfield MO 65810-1785 |
| Practice Telephone | 4178811411 |
| Mailing Telephone | 4178811411 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES REIKER (TREASURER) |
| Authorized Official Telephone | 5734711113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Lakewood Assisted Living | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851803431 | Lakewood Residential Care, LLC | Residential Treatment Facility, Physical Disabilities | 12045 Lakewood Blvd, Downey, CA 90242-2635 | 2017-11-03 |
| Street Address |
4685 S ROBBERSON AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65810-1785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508373838 | Sunterra Springfield Oc, LLC | Skilled Nursing Facility | 4935 S National Ave, Springfield, MO 65810 | 2018-01-09 |
| 1982119392 | Boyoung Park | Specialist/Technologist | 4355 S National Ave Apt 905, Springfield, MO 65810 | 2017-12-07 |
| 1578086310 | Missouri Telerad LLC | Radiology | 5117 South Neffleton Avenue, Springfiled, MO 65810 | 2017-07-24 |
| 1245597285 | Intrepid of Missouri, Inc. | Hospice Care, Community Based | 4305 S. National Ave., Springfield, MO 65810 | 2012-04-16 |
| 1700199668 | Telerad of Mo Account Management, LLC | Radiology | 5117 S. Neffleton Ave, Springfield, MO 65810 | 2010-07-21 |
| 1427286251 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 745 W El Camino Alto Drive, Springfield (s), MO 65810 | 2009-07-01 |
| 1033344304 | Teresa Mary Kaelin | Occupational Therapist | 3291 W. Ridge Run, Springfield, MO 65810 | 2009-05-15 |
| 1538366448 | Rani K Nair | Internal Medicine | 3231 S National Mercy Endocrineology, Ste 440, Springfield, MO 65810 | 2007-07-03 |
| 1467672519 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 4955 S. National Ave., Unit A, Springfield, MO 65810 | 2007-04-30 |
| 1336161983 | Leo Allan Tokarczyk | Dentist | 4777 S National Ave, Springfield, MO 65810 | 2006-07-24 |
| Find all providers in zip 65810 | ||||
| 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 |
|---|---|---|---|---|
| 1871107482 | Springfield Residential, LLC | Assisted Living Facility | 2530 South Main Street, Springfield, TN 37172 | 2020-09-01 |
| 1649835034 | Joyco, Inc. | Assisted Living Facility | 2030 W Mount Vernon St, Springfield, MO 65802-4846 | 2019-05-01 |
| 1033648274 | Creekside At Elfindale | Assisted Living Facility | 1601 S Fort Ave, Springfield, MO 65807-8430 | 2017-06-10 |
| 1386039659 | Snh Al Aimo Tenant, Inc. | Assisted Living Facility | 3540 E Cherokee St, Springfield, MO 65809-2833 | 2015-04-02 |
| 1023403391 | Snh Al Aimo Tenant, Inc. | Assisted Living Facility | 2410 W Chesterfield Blvd, Springfield, MO 65807-8889 | 2015-04-02 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1851793285 | Timberlake Estates Slf, Lp | Assisted Living Facility | 2521 Empowerment Rd, Springfield, IL 62703-4983 | 2014-09-17 |
| 1851664981 | Sunrise Springfield Assisted Living LLC | Assisted Living Facility | 6541 Franconia Rd, Springfield, VA 22150-1801 | 2012-02-21 |
| 1215209226 | Bslc II | Assisted Living Facility | 1302 West Sunset, Springfield, MO 65807-5943 | 2012-02-07 |
| 1497998918 | Timberlake Senior Living | Assisted Living Facility | 2521 Empowerment Road, Springfield, IL 62703 | 2009-04-14 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65810 |
Please comment or provide details below to improve the information on LAKEWOOD RESIDENTIAL CARE, LLC.
| 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.