Organization Active NPI

Lakeside at Farmerville LLC

  • Skilled Nursing Facility
  • Farmerville, LA
National Provider Identifier
1871469783
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAKESIDE AT FARMERVILLE LLC
Practice address
813 N Main St
Farmerville, LA 71241-2217
Phone
(847) 221-6444
NPI assigned
Oct 16, 2025
Last updated
Oct 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Authorized official

Name
Abraham Gutnicki
Title
Medicare Authorized Official
Phone
(847) 221-6444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

813 N Main St
Farmerville, LA 71241-2217

Mailing address

6865 N Lincoln Ave
Lincolnwood, IL 60712-4611

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1871469783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6865 N LINCOLN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607124611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 N MAIN ST",
            "city": "FARMERVILLE",
            "state": "LA",
            "postal_code": "712412217",
            "telephone_number": "847-221-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE AT FARMERVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "GUTNICKI",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_title_or_position": "MEDICARE AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "847-221-6444"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmerville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.