Provider Demographics
NPI:1932812815
Name:LAKEWOOD HEALTHCARE LLC
Entity Type:Organization
Organization Name:LAKEWOOD HEALTHCARE LLC
Other - Org Name:SIERRA POST ACUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EX VP AND GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-447-9829
Mailing Address - Street 1:1432 DEPEW ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-2237
Mailing Address - Country:US
Mailing Address - Phone:303-238-1375
Mailing Address - Fax:
Practice Address - Street 1:1432 DEPEW ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-2237
Practice Address - Country:US
Practice Address - Phone:303-238-1375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility