Lakeside Haven Management Group

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

Legal business name

LAKESIDE HAVEN MANAGEMENT GROUP

Practice address

3723 Long Lake Rd
Cheboygan, MI 49721-9276

Phone

(231) 333-7333

NPI assigned

Oct 16, 2024

Organization subpart

No

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

Authorized official

Name

Megan Charboneau, RN

Title

Owner

Phone

(231) 333-7333

Specialties & licenses 1

Addresses

Other names 1

• Lakeside Home Care Doing business as

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1548080187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 LONG LAKE RD",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497219276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 LONG LAKE RD",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497219276",
            "telephone_number": "231-333-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE HAVEN MANAGEMENT GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "CHARBONEAU",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-333-7333",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edward Paul Kosanke, O.D.
• Jody Kosanke, MA, CCC-SLP
• Zoey Kowalski, LLMSW
• Abby Kroczaleski
• Mathew Robert Laberge
• Lakeside Home Care Services LLC
• Abbi Jo Lalond
• Kaitlin Marie Lalonde, PA-C
• Leja Jackson Inc
• Loretta M Leja, M.D.

• Home Health Registered Nurse in Cheboygan, MI
• Providers in Cheboygan, MI by specialty
• Home Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.