Organization · NPI-2

Florida Ph-I, LLC

Skilled Nursing Facility · Lakeland, FL

NPI number1831433531
StatusActive
Last updated in NPPESNov 19, 2012

Details

NPI
1831433531
Entity type
Organization (NPI-2)
Legal business name
Florida Ph-I, LLC
Organization subpart
Yes
Enumeration date
Nov 19, 2012
Last updated
Nov 19, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
314000000X Skilled Nursing FacilitySNF130470964FLYes
310400000X Assisted Living FacilityAL4790FL

Practice location

16 Lake Hunter Dr
Lakeland, FL 33803-1297

Phone 863-577-6040

Mailing address

16 Lake Hunter Dr
Lakeland, FL 33803-1297

Authorized official

Patty Fekete
Asst Treasurer/Director Of Finance
8635776040

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