Provider Demographics
NPI:1982650206
Name:LAKEVIEW MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:LAKEVIEW MEDICAL CENTER, LLC
Other - Org Name:LAKEVIEW REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BRESLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-867-4446
Mailing Address - Street 1:95 JUDGE TANNER BLVD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7500
Mailing Address - Country:US
Mailing Address - Phone:985-867-3800
Mailing Address - Fax:985-867-4449
Practice Address - Street 1:195 HIGHLAND PARK ENTRANCE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7164
Practice Address - Country:US
Practice Address - Phone:985-867-3800
Practice Address - Fax:985-867-4449
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAKEVIEW MEDICAL CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-26
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
19S177Medicare Oscar/Certification