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NPI Code Detail

MEDICARE: LANIER TERRACE LLC

MEDICARE: LANIER TERRACE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityFL

General Provider Information

NPI Number : 1265837314
Entity Type Code : Organization
Provider Name (Legal Business Name) : LANIER TERRACE LLC
Provider Business Mailing Address
First Line : 12740 LANIER RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32226-1704
Country : US
Telephone Number : 386-366-0254
Fax Number : 305-899-0201
Provider Business Practice Location Address
First Line : 12740 LANIER RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32226-1704
Country : US
Telephone Number : 386-366-0254
Fax Number : 305-899-0201
Authorized Official
Title or Position : ADMINISTRATOR
Name : SIDNEY ROBERTS
Credential :
Telephone Number : 386-366-0254
Provider Enumeration Date : 10/31/2014
Last Update Date : 12/05/2014

Similar Medicare Providers

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Practice Location Address:
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Practice Fax:
1932685880 — LANIER REHABILITATION CENTER LLC
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1245001437 — CHRYSTAL ELIZABETH NELSON
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1669406260 — DR. HALE E HEDLEY MD
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Directions to “LANIER TERRACE LLC ” Practice Location

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