Provider Demographics
NPI:1881265171
Name:LAKELAND HOME HEALTHCARE
Entity type:Organization
Organization Name:LAKELAND HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-239-2075
Mailing Address - Street 1:1446 116TH ST
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-5569
Mailing Address - Country:US
Mailing Address - Phone:715-239-2075
Mailing Address - Fax:715-239-2116
Practice Address - Street 1:1446 116TH ST
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-5569
Practice Address - Country:US
Practice Address - Phone:715-239-2075
Practice Address - Fax:715-239-2116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility