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SOUTHERN LIFESTYLE ALF OF LAKE PLACID LLC

Alzheimer Center

Lake Placid, Florida

Provider NPI: 1528207693

Organization Information:
Organization Name:  SOUTHERN LIFESTYLE ALF OF LAKE PLACID LLC


Practice Location:
1297 US 27 N  LAKE PLACID, FL 33852 US
Tel: 863-465-0568  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N311500000XNursing & Custodial Care Facilities
Alzheimer Center (Dementia Center)
FLAL11211
Y310400000XNursing & Custodial Care Facilities
Assisted Living Facility
FLAL11211

Other Provider Identifiers:

IssuerNumberStateType
MEDICAID WAIVER000266800FL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ALZHEIMERS JOBS FL - Page 1



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