03D1094089 CLIA NUMBER - LAKE VIEW TERRACE MEMORY CARE

Laboratory Demographics

CLIA Number: 03D1094089

Facility Name: LAKE VIEW TERRACE MEMORY CARE

Facility Address:
320 LAKE HAVASU AVE NORTH
LAKE HAVASU CITY, AZ
ZIP 86403
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Facility Phone Number: 928 855-8099

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1033440458

Taxonomy: 311500000X - Alzheimer Center (Dementia Center)
A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.

CLIA Record

Field Name	Field Value
CLIA Number	03D1094089
LAB Type	Assisted Living Facility
Facility Name	LAKE VIEW TERRACE MEMORY CARE
Street	320 LAKE HAVASU AVE NORTH
City	LAKE HAVASU CITY
State	AZ
ZIP	86403
Phone	928 855-8099
CertificateType	4
CertificateEffectiveDate	1/9/2023
CertificateExpirationDate	1/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024