Lakebridge a Waters Community LLC
NPI #1043763592 in Johnson City, Tennessee
Provider Information
- NPI Number
- 1043763592
- Entity Type
- Organization
- Organization Name
- Lakebridge a Waters Community LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Aug 2, 2016
- Last Updated
- Aug 2, 2016
Practice Location
- Address
- 115 WOODLAWN DR
- City
- Johnson City
- State
- Tennessee
- ZIP Code
- 37604-5978
- Phone
- (423) 975-0095
Authorized Official
- Name
- MOISHE GUBIN
- Title
- MEMBER
- Phone
- (708) 449-1900
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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