Lakeside Care Center LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

20053290A Issued in OK

Legal business name

LAKESIDE CARE CENTER LLC

Practice address

1025 N Adams Rd
Sand Springs, OK 74063-8110

Phone

(918) 245-5908

Fax

(918) 245-3079

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Patty Jean Eisenmann, ADMINISTRATOR

Title

Administrator

Phone

(918) 545-5908

Specialties & licenses 1

Addresses

Other names 1

• OAKDALE MANOR Other name

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1619985918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N ADAMS RD",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740638110",
            "telephone_number": "918-245-5908",
            "fax_number": "918-245-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N ADAMS RD",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740638110",
            "telephone_number": "918-245-5908",
            "fax_number": "918-245-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "EISENMANN",
        "authorized_official_first_name": "PATTY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "918-545-5908",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OK",
            "license": "20053290A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OAKDALE MANOR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gayle Deanne Koger
• Sarah Charlotte Kohl, RN
• Kaitlin Nikole Kuehne, PHARMD
• Alexander Kvach, D.C.
• L & a Investments
• Brandon Lane, D.O.
• Benjamin Clay Langley, L.C.S.W.
• Erin Jennifer Latimer, MD
• Laura K Riggins OD PC
• Brandy C Lembke, APRN-CNP

• Nursing Facility/Intermediate Care Facility in Sand Springs, OK
• Providers in Sand Springs, OK by specialty
• Nursing Facility/Intermediate Care Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.