Active NPI
Lakeview House Inc
- Skilled Nursing Facility
- Haverhill, MA
National Provider Identifier
1215921747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1373
- Legal business name
- LAKEVIEW HOUSE INC
- Practice address
- 87 Shattuck St
Haverhill, MA 01830-2319 - Phone
- (978) 372-1081
- Fax
- (978) 372-0681
- NPI assigned
- Sep 12, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jon Guarino, NHA
- Title
- Administrator
- Phone
- (978) 372-1081
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1373 | MA | Primary |
Addresses
Primary practice location
87 Shattuck St
Haverhill, MA 01830-2319
Mailing address
87 Shattuck St
Haverhill, MA 01830-2319
Phone (978) 372-1081
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0914495 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111216000471 | MA | Part A Provider - Skilled Nursing Facility | 3577738756 | Practice locations: Haverhill, MA |
Skilled nursing facility certification: CCN 225401
- Legal name
- LAKEVIEW HOUSE INC
- Doing business as
- LAKEVIEW HOUSE SKILLED NURSING AND RESIDENTIAL CARE FACILITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1990
- Last certification
- Aug 7, 2024
- Beds
- 91
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Enrollment address
- 87 Shattuck St
Haverhill, MA 01830-2319 - Nursing home name
- LAKEVIEW HOUSE SKLD NRSG AND RESIDENTIAL CARE FAC
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Lakeview House SKLD NRSG and Residential Care Fac
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 1, 1990
- Medicare certification status
- Active
- Certified beds
- 91
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D0927675 | Lakeview House Nursing Home | Certificate of waiver | Apr 24, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Joseph E Romatelli | Operational/Managerial Control | Dec 9, 2019 | |
| Adp of the SNF | Dec 9, 2019 | ||
| Jon D Guarino | 5% Or Greater Direct Ownership Interest | Jul 1, 1983 | 50% |
| Corporate Officer | Jul 1, 1983 | 100% | |
| Operational/Managerial Control | Jul 1, 1983 | ||
| Adp of the SNF | Jul 1, 1983 | ||
| Direct Ownership Interest | Jul 1, 1983 | 50% | |
| William P Grimes | Operational/Managerial Control | Dec 9, 2019 | |
| Adp of the SNF | Dec 9, 2019 | ||
| Adp of the SNF | Jan 29, 2025 | ||
| Kathleen a Gaurino | 5% Or Greater Direct Ownership Interest | Jul 1, 1983 | 50% |
| Adp of the SNF | Jul 1, 1983 | ||
| Direct Ownership Interest | Jul 1, 1983 | 50% |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Haverhill, MA
- NPI 1760589147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320624000000",
"number": "1215921747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 SHATTUCK ST",
"city": "HAVERHILL",
"state": "MA",
"postal_code": "018302319",
"telephone_number": "978-372-1081",
"fax_number": "978-372-0681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 SHATTUCK ST",
"city": "HAVERHILL",
"state": "MA",
"postal_code": "018302319",
"telephone_number": "978-372-1081",
"fax_number": "978-372-0681"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKEVIEW HOUSE INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-12",
"last_updated": "2011-11-07",
"status": "A",
"authorized_official_last_name": "GUARINO",
"authorized_official_first_name": "JON",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "978-372-1081",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "NHA"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MA",
"license": "1373",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0914495",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Haverhill, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.