Healthcare Provider Details

I. General information

NPI: 1902264641
Provider Name (Legal Business Name): LAFAYETTE OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2016
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 W MAIN ST
MAYO FL
32066-4136
US

IV. Provider business mailing address

410 MONMOUTH AVE APT 201
LAKEWOOD NJ
08701-3747
US

V. Phone/Fax

Practice location:
  • Phone: 386-294-3300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: HENRY STEINMETZ
Title or Position: MANAGER
Credential:
Phone: 732-813-5000