Senior Health-Lakeside, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4622 Issued in TX

Legal business name

SENIOR HEALTH-LAKESIDE, LLC

Practice address

4306 24TH St
Lubbock, TX 79410-1818

Phone

(806) 793-2555

Fax

(806) 793-9835

NPI assigned

Jul 7, 2005

Last updated

Aug 30, 2007By 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

Shannon Lynn Jantzen, LNFA

Title

Administrator

Phone

(806) 793-2555

Specialties & licenses 1

Addresses

Tax ID family

Lakeside Rehabilitation and Care Center2 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.

• Lakeside Senior Care LLC

  dba Lakeside Rehabilitation and Care Center

  • Skilled Nursing Facility
  • Lubbock, TX
  • NPI 1902040223
  NPD tax ID

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1437156171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4306 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101818",
            "telephone_number": "806-793-2555",
            "fax_number": "806-793-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4306 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101818",
            "telephone_number": "806-793-2555",
            "fax_number": "806-793-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR HEALTH-LAKESIDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "JANTZEN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "806-793-2555",
        "authorized_official_credential": "LNFA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "4622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Sell, CRNA
• Ashley Nicole Sellers
• Laura Seltzer, MS, CCC-SLP
• Joseph Sena, MD
• Karen Sue Sena, RN
• Senior Medical Solutions, LLC
• Senior Solace LLC
• Shawn James Senter, MD
• Michael Duke Seo, D.D.S.
• Serl Indiana Acquisition Partners LLC

• Skilled Nursing Facility in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.