- Enrollment id
- O20100331000462
- Enrollment state
- NM
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1487644464
- Multiple npi flag
- N
- Ccn
- 325087
- Associate id
- 7719013580
- Organization name
- LAKEVIEW CHRISTIAN HOME OF THE SOUTHWEST, INC.
- Doing business as name
- NORTHGATE UNIT OF LAKEVIEW CHRISTIAN HOME
- Incorporation date
- 1960-08-03
- Incorporation state
- NM
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- NORTHGATE UNIT OF LAKEVIEW CHRISTIAN HOME
- Address line 1
- 1905 W PIERCE ST
- City
- CARLSBAD
- State
- NM
- Zip code
- 882204025