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General NPI Number Information
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NPI Number | 1679231450
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Entity Type | Organization
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Legal Business Name | TERRACE OF LAKE WORTH LLC
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 1201 12TH AVE S
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City | LAKE WORTH
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State | FL
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Zip | 33460-5409
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Country | US
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Telephone | 561-586-7404
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Fax |
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Provider Business Mailing Address
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Address Line | 4655 W CHASE AVE
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-1605
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Country | US
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Telephone | 847-262-3800
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MEIR MEYSTEL
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Credential |
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Telephone | 847-262-3800
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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 |
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