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General NPI Number Information
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NPI Number | 1174999726
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Entity Type | Organization
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Legal Business Name | LAKELAND NURSING AND REHABILITATION, LLC
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 1919 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-2901
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Country | US
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Telephone | 863-688-5612
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Fax |
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Provider Business Mailing Address
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Address Line | 7383 N LINCOLN AVE SUITE 100
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-1734
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Country | US
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Telephone | 847-440-2233
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MOSHE DAVID ARYEH
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Credential |
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Telephone | 847-440-2233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | FL
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