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NPI Code Detail

MEDICARE: LAKELAND NURSING AND REHABILITATION, LLC

MEDICARE: LAKELAND NURSING AND REHABILITATION, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174999726
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKELAND NURSING AND REHABILITATION, LLC
Provider Business Mailing Address
First Line : 7383 N LINCOLN AVE
Second Line : SUITE 100
City : LINCOLNWOOD
State : IL
Zip : 60712-1734
Country : US
Telephone Number : 847-440-2233
Fax Number :
Provider Business Practice Location Address
First Line : 1919 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-2901
Country : US
Telephone Number : 863-688-5612
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : MOSHE DAVID ARYEH
Credential :
Telephone Number : 847-440-2233
Provider Enumeration Date : 08/18/2015
Last Update Date : 08/18/2015

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