Healthcare Provider Details

I. General information

NPI: 1205804390
Provider Name (Legal Business Name): LPSNF INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 MASTERPIECE WAY
PALM BEACH GARDENS FL
33410
US

IV. Provider business mailing address

3600 MASTERPIECE WAY
PALM BEACH GARDENS FL
33410
US

V. Phone/Fax

Practice location:
  • Phone: 561-514-5156
  • Fax: 561-625-7930
Mailing address:
  • Phone: 561-514-5156
  • Fax: 561-625-7930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SAMUEL G SANDERS
Title or Position: CONTROLLER
Credential: CPA
Phone: 863-324-1616