Lake Pleasant Healthcare, Inc.

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

LAKE PLEASANT HEALTHCARE, INC.

Practice address

20625 N Lake Pleasant Rd
Peoria, AZ 85382-9704

Phone

(623) 566-0642

Fax

(623) 476-3664

NPI assigned

Apr 29, 2019

Organization subpart

No

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

Authorized official

Name

Soon Burnam

Title

Treasurer

Phone

(949) 540-1249

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lake Pleasant Post Acute Rehabilitation Center Doing business as

Tax ID family

Esolutions Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Lake Pleasant Healthcare, Inc.

  • Skilled Nursing Facility
  • Peoria, AZ
  • NPI 1083094965
  NPD tax ID
• Life Care Centers of America, Inc.

  • Skilled Nursing Facility
  • Peoria, AZ
  • NPI 1700823606
  NPD tax ID

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556496000000",
    "number": "1376107904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20625 N LAKE PLEASANT RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829704",
            "telephone_number": "623-566-0642",
            "fax_number": "623-476-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20625 N LAKE PLEASANT RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829704",
            "telephone_number": "623-566-0642",
            "fax_number": "623-476-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE PLEASANT HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-29",
        "last_updated": "2019-04-29",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPARTMENT OF HEALTH SERVICES",
            "identifier": "OTC9114",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Pleasant Post Acute Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tung Thanh Lai, RPH
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• Lake Pleasant Family Dental
• Lake Pleasant Healthcare, Inc.
• Lake Pleasant Internal Medicine PLC
• Lake Pleasant Kids Dentists and Orthodontics, LLP
• Lake Pleasant Orthodontic Specialists
• Lakeview Lab
• Corrin Helen Lakomski, NP-C

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.