NPIMap

Organization Active NPI

Lake Hospital System, Inc.

Doing business as Lake Health Home Care Services

  • Home Health Agency
  • Mentor, OH
National Provider Identifier
1568514636
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LAKE HOSPITAL SYSTEM, INC.
Doing business as
Lake Health Home Care Services
Practice address
9485 Mentor Ave
Suite A04
Mentor, OH 44060-4597
Phone
(440) 639-0900
Fax
(440) 357-4583
NPI assigned
Jan 17, 2007
Last updated
May 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Authorized official

Name
Mr. Michael Kittoe
Title
VP Finance, Cfo
Phone
(440) 354-1051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

9485 Mentor Ave
Suite A04
Mentor, OH 44060-4597

Mailing address

7590 Auburn Rd
Concord TWP, OH 44077-9176
Phone (440) 375-8700

Other identifiers 1

IdentifierTypeStateIssuer
0665221MedicaidOH

Other names 1

  • Lake Health Home Care Services Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1568514636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 AUBURN RD",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440779176",
            "telephone_number": "440-375-8700",
            "fax_number": "440-354-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9485 MENTOR AVE",
            "address_2": "SUITE A04",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604597",
            "telephone_number": "440-639-0900",
            "fax_number": "440-357-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE HOSPITAL SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "KITTOE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VP FINANCE, CFO",
        "authorized_official_telephone_number": "440-354-1051",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665221",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Health Home Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.