Provider Demographics
NPI:1376680470
Name:LAKELAND COMMUNITY HOSPITAL INC.
Entity Type:Organization
Organization Name:LAKELAND COMMUNITY HOSPITAL INC.
Other - Org Name:NORTHWEST HOME HEALTH-HALEYVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:CLAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-269-4074
Mailing Address - Street 1:42024 HIGHWAY 195
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565-7054
Mailing Address - Country:US
Mailing Address - Phone:205-486-5213
Mailing Address - Fax:205-485-7127
Practice Address - Street 1:42024 HIGHWAY 195
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565-7054
Practice Address - Country:US
Practice Address - Phone:205-486-5213
Practice Address - Fax:205-485-7127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL017109Medicare Oscar/Certification