Lakeshore Regional Entity

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LAKESHORE REGIONAL ENTITY

Practice address

920 Diana St
Ludington, MI 49431-1987

Phone

(231) 845-6294

Fax

(231) 845-7095

NPI assigned

Oct 2, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Alan Laban II

Title

Cfo

Phone

(231) 769-2046

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1083041297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 HAKES DR.",
            "address_2": "SUITE 500",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "49441",
            "telephone_number": "231-769-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DIANA ST",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311987",
            "telephone_number": "231-845-6294",
            "fax_number": "231-845-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE REGIONAL ENTITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-02",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "LABAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "231-769-2046",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sceone Maren Kraai, PA-C
• Leah Erin Kruk, DNP FNP
• Carol Ann Kubanek-Erdman, R.N.
• Sarah Kucera
• Nathaniel Thomas Ladaga, DO
• Lakeshore Spine and Pain P C
• Lakeshore Spine and Pain PC
• Lakeshore Vein &Laser Clinic PLLC
• Lakewinds Dental Centre
• Britney Laman, LMSW

• Community/Behavioral Health Agency in Ludington, MI
• Providers in Ludington, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.