Provider Demographics
NPI:1871846493
Name:LAKEWOOD HEALTHCARE, INC.
Entity Type:Organization
Organization Name:LAKEWOOD HEALTHCARE, INC.
Other - Org Name:SLOAN'S LAKE REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-540-1249
Mailing Address - Street 1:1601 NORTH LOWELL BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-1545
Mailing Address - Country:US
Mailing Address - Phone:303-534-2211
Mailing Address - Fax:303-534-2212
Practice Address - Street 1:1601 NORTH LOWELL BOULEVARD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1545
Practice Address - Country:US
Practice Address - Phone:303-534-2211
Practice Address - Fax:303-534-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility