Healthcare Provider Details

I. General information

NPI: 1174527907
Provider Name (Legal Business Name): LAKELAND HILLS REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 E BELLA VISTA ST
LAKELAND FL
33805-3008
US

IV. Provider business mailing address

1665 PALM BEACH LAKES BLVD STE 400
WEST PALM BEACH FL
33401-2108
US

V. Phone/Fax

Practice location:
  • Phone: 863-688-8591
  • Fax: 863-683-6705
Mailing address:
  • Phone: 561-223-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1279095
License Number StateFL

VIII. Authorized Official

Name: HOWARD JAFFE
Title or Position: PRESIDENT
Credential:
Phone: 215-346-6454