Provider Demographics
NPI:1184905622
Name:LAKEVIEW CARE PARTNERS
Entity type:Organization
Organization Name:LAKEVIEW CARE PARTNERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO & ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-534-7297
Mailing Address - Street 1:515 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53964-9046
Mailing Address - Country:US
Mailing Address - Phone:262-782-7228
Mailing Address - Fax:262-534-7257
Practice Address - Street 1:515 S MARKET ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:WI
Practice Address - Zip Code:53964-9046
Practice Address - Country:US
Practice Address - Phone:262-782-7228
Practice Address - Fax:262-534-7257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness