Lakeland Specialty Hospital

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

113010 Issued in MI

Legal business name

LAKELAND SPECIALTY HOSPITAL

Practice address

6418 Deans Hill Rd
Berrien Center, MI 49102-9750

Phone

(269) 473-3003

NPI assigned

Sep 21, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terry Stanard

Title

Administrator

Phone

(269) 473-3003

Specialties & licenses 1

Addresses

Tax ID family

Lakeland Pharmacy Berrien2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lakeland Pharmacy Berrien

  • Institutional Pharmacy
  • Berrien Center, MI
  • NPI 1902968084
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033105549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 DEANS HILL RD",
            "city": "BERRIEN CENTER",
            "state": "MI",
            "postal_code": "491029750",
            "telephone_number": "269-473-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6418 DEANS HILL RD",
            "city": "BERRIEN CENTER",
            "state": "MI",
            "postal_code": "491029750",
            "telephone_number": "269-473-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND SPECIALTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STANARD",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "269-473-3003"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "113010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Johnson-Mastin
• Tricia Newland Johnson, L.M.S.W
• Thomas Johnston
• Karen Joy Knauss, RD
• Lakeland Pharmacy Berrien
• Lakeland Specialty Hospital at Berrien Center
• Lakeland Specialty Hospital at Berrien Center
• Laura Marie Landrey, R.D.
• Leslie Louise Liles
• Patricia Lisowski, CCAR

• Skilled Nursing Facility in Berrien Center, MI
• Providers in Berrien Center, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.