LAKE HOSPITAL SYSTEM, INC (NPI# 1225264146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225264146 |
| Entity Type | Organization |
| Organization Name | LAKE HOSPITAL SYSTEM, INC |
| Practice Address |
36000 Euclid Ave Willoughby OH 44094-4625 |
| Practice Telephone | 4409539600 |
| Practice Fax Number | 4409536081 |
| Mailing Telephone | 4409539600 |
| Mailing Fax Number | 4409536081 |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2011-06-16 |
| Authorized Official Name | MR. ROBERT TRACZ (CFO) |
| Authorized Official Telephone | 4403541055 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PTAN | 36S098 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699000281 | Lake Hospital System, Inc | Clinic/Center | 74 S Park Place, Painesville, OH 44077 | 2009-10-15 |
| 1134189376 | Lake Hospital System, Inc | Internal Medicine | 6270 N Ridge Rd, Madison, OH 44057-2567 | 2006-03-23 |
| 1205896404 | Lake Hospital System, Inc | Clinic/Center | 7956 Tyler Blvd, Mentor, OH 44060-4806 | 2006-03-23 |
| 1356675003 | Lake Hospital System, Inc | Clinic/Center | 7590 Auburn Rd, Concord Twp, OH 44077-9176 | 2009-09-29 |
| 1689634966 | Lake Hospital System, Inc | Internal Medicine | 510 5th Ave, Chardon, OH 44024-1077 | 2006-03-23 |
| Street Address |
36000 EUCLID AVE |
| City | WILLOUGHBY |
| State | OH |
| Zip Code | 44094-4625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356340061 | Gary Salovon | Anesthesiology | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2005-07-15 |
| 1568070548 | Nicole Lepore | Social Worker | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2020-07-16 |
| 1881202026 | Marwa Azem | Pharmacist | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2020-07-14 |
| 1053941195 | Dornice Ivanna Friday | Social Worker | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2020-01-16 |
| 1477013373 | Karolin Seifried Ash | Social Worker | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2019-03-25 |
| 1861959546 | Marlarie C Hardee | Nurse Anesthetist, Certified Registered | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2019-02-28 |
| 1578020905 | Orsolya Eads | Nurse Practitioner | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2019-02-21 |
| 1922586379 | Jonathon Eleeot Henry | Social Worker | 36000 Euclid Ave, Willoughby, OH 44094 | 2018-07-29 |
| 1023595139 | Katherine Elvira Mccormick | Social Worker | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2018-07-20 |
| 1922598291 | James V Czernicki | Anesthesiologist Assistant | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2018-05-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574367 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 36596 Euclid Ave, Willoughby, OH 44094 | 2020-09-25 |
| 1679111322 | Megan King | Nurse Practitioner | 4078 Erie Street, Unit B, Willoughby, OH 44094 | 2019-12-12 |
| 1124661525 | Mind and Body Infusion Therapies, LLC | Clinic/Center | 9264 Chillicothe Rd., Unit #2, Kirtland, OH 44094 | 2019-10-18 |
| 1679125637 | Christina Maria Chandler | Family Medicine | 39021 Signature Circle, Willoughby, OH 44094 | 2019-07-10 |
| 1467920595 | Rachel Curry | Specialist/Technologist | 53400 Euclid Ave., Apt. E-102, Willoughby, OH 44094 | 2018-11-07 |
| 1437649753 | Katie Lauren Greenaway | Registered Nurse | 5103 Robinhood Dr, Willoughby, OH 44094 | 2018-05-11 |
| 1003346131 | Heather Marie Hayes | Licensed Practical Nurse | 38882 Mentor Ave., Willoughby, OH 44094 | 2017-06-12 |
| 1609305028 | Ann Marie Mason | Counselor | 38882 Mentor Avenue, Willoughby, OH 44094 | 2017-06-08 |
| 1285173005 | Mattie Diann Towns-scott | Social Worker | 34950 Chardon Road, Bldg 2, Suite 210, Willoughby Hills, OH 44094 | 2017-02-13 |
| 1447797329 | Therese Benz | General Acute Care Hospital | 96000 Euclid Ave., Willoughby, OH 44094 | 2017-01-30 |
| Find all providers in zip 44094 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972689172 | Lake Hospital System Inc | Psychiatric Unit | 36000 Euclid Ave, Willoughby, OH 44094-4662 | 2006-10-31 |
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| 1093256059 | Usaf | Psychiatric Unit | 418 Shrewsbury St, Holland, OH 43528-8568 | 2017-03-10 |
| 1235493990 | Mifflin Youth Group | Psychiatric Unit | 1688 Schrock Rd, Columbus, OH 43229-1500 | 2012-06-27 |
| 1851547392 | Ipg Rs LLC | Psychiatric Unit | 17872 Lincoln Hwy, Middle Point, OH 45863-9700 | 2008-08-15 |
| 1649441817 | Western Ohio Psychiatric Institute, LLC | Psychiatric Unit | 601 Edwin Moses Boulevard, Dayton, OH 45408 | 2008-03-17 |
| 1073568994 | Windsor Hospital | Psychiatric Unit | 115 E Summit St, Chagrin Falls, OH 44022-2711 | 2006-05-23 |
| 1457314502 | Medical University of Ohio At Toledo | Psychiatric Unit | 3000 Arlington Ave # Ms 1166, Toledo, OH 43614-2595 | 2006-04-10 |
| 1598765000 | Defiance Hospital Inc. | Psychiatric Unit | 1200 Ralston Ave, Defiance, OH 43512-1396 | 2005-07-26 |
| 1053944967 | University Hospitals Cleveland Medical Center | Psychiatric Unit | 5805 Euclid Ave Ste 100, Cleveland, OH 44103-3715 | 2020-02-19 |
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| City | WILLOUGHBY |
| Zip Code | 44094 |
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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.