Provider Demographics
NPI:1700216777
Name:LAKEVIEW HEALTH CARE SERVICES INC
Entity Type:Organization
Organization Name:LAKEVIEW HEALTH CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:O'GONUWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-218-4440
Mailing Address - Street 1:3405 VIOLET LN
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-2796
Mailing Address - Country:US
Mailing Address - Phone:219-218-4440
Mailing Address - Fax:
Practice Address - Street 1:1112 US HIGHWAY 41
Practice Address - Street 2:SUITE 210
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1361
Practice Address - Country:US
Practice Address - Phone:219-218-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health