National Provider Identifier Database

LAKELAND VILLAGE
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

LAKELAND VILLAGE
S 2320 SALNAVE ROAD
MEDICAL LAKE, WA99022-0200
Phone: 509-299-1001
Fax: 509-299-1070
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for LAKELAND VILLAGE

NPI Number 1366594228
Legal business name
LBN
LAKELAND VILLAGE
Authorized official KATHRYN MONTAGUE - (SUPERINTENDENT)
Entity Organization
Organization subpart No
Enumeration date 01/18/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • WA Medicaid: 4012001

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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