Organization · NPI-2

1010 Carpenters Way Operations LLC

Skilled Nursing Facility · Lakeland, FL

NPI number1508135476
StatusActive
Last updated in NPPESNov 27, 2023

Details

NPI
1508135476
Entity type
Organization (NPI-2)
Legal business name
1010 Carpenters Way Operations LLC
Organization subpart
No
Enumeration date
Dec 22, 2011
Certification date
May 18, 2020
Last updated
Nov 27, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
314000000X Skilled Nursing FacilitySNF130470996FLYes

Other names

  • Wedgewood Healthcare Center (Doing Business As)

Practice location

1010 Carpenters Way
Lakeland, FL 33809-3926

Phone 863-815-0488 · Fax 863-815-0580

Mailing address

1010 Carpenters Way
Lakeland, FL 33809-3926

Phone 863-815-0488 · Fax 863-815-0580

Authorized official

Kenneth Ussery
Vp
4075711550

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