- Enrollment id
- O20161207000591
- Enrollment state
- NM
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1487644464
- Multiple npi flag
- N
- Ccn
- 327161
- Associate id
- 7719013580
- Organization name
- LAKEVIEW CHRISTIAN HOME OF THE SOUTHWEST, INC.
- Doing business as name
- LAKEVIEW CHRISTIAN HOME HEALTH
- Incorporation date
- 1961-08-01
- Incorporation state
- NM
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 1300 N CANAL ST
- City
- CARLSBAD
- State
- NM
- Zip code
- 882204600
- Practice location type
- HHA BRANCH