Provider Demographics
NPI:1104360510
Name:LAKEVIEW LIVING, LLC
Entity Type:Organization
Organization Name:LAKEVIEW LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-480-0346
Mailing Address - Street 1:404 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:FIRTH
Mailing Address - State:NE
Mailing Address - Zip Code:68358-6305
Mailing Address - Country:US
Mailing Address - Phone:402-791-5588
Mailing Address - Fax:402-791-2404
Practice Address - Street 1:404 E 8TH ST
Practice Address - Street 2:
Practice Address - City:FIRTH
Practice Address - State:NE
Practice Address - Zip Code:68358-6305
Practice Address - Country:US
Practice Address - Phone:402-791-5588
Practice Address - Fax:402-791-2404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility