| Lake Hospital System, Inc | |
| 
					10977 Capital Pkwy Concord Twp OH 44077-9394  | |
| (440) 918-6366 | |
| Not Available | 
| Full Name | Lake Hospital System, Inc | 
|---|---|
| Speciality | Psychiatric Unit | 
| Location | 10977 Capital Pkwy, Concord Twp, Ohio | 
| Authorized Official Name and Position | Anthony Schillero (DIRECTOR OF FINANCIAL PLANNING) | 
| Authorized Official Contact | 2167678141 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lake Hospital System, Inc 36000 Euclid Ave Willoughby OH 44094-4625 Ph: (440) 953-9600  | Lake Hospital System, Inc 10977 Capital Pkwy Concord Twp OH 44077-9394 Ph: (440) 918-6366  | 
| NPI Number | 1225264146 | 
|---|---|
| Provider Enumeration Date | 06/05/2009 | 
| Last Update Date | 06/10/2025 | 
| Certification Date | 06/10/2025 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1225264146 | NPI | - | NPPES | 
| 36S098 | Other | PTAN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary | 
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