Provider Demographics
NPI:1407010978
Name:LAWNWOOD COMMONS OPERATING LLC
Entity Type:Organization
Organization Name:LAWNWOOD COMMONS OPERATING LLC
Other - Org Name:THE LYNMOORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:ASSIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-565-7820
Mailing Address - Street 1:1550 N LAWNWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4972
Mailing Address - Country:US
Mailing Address - Phone:772-489-6800
Mailing Address - Fax:772-461-6072
Practice Address - Street 1:1550 N LAWNWOOD CIR
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4972
Practice Address - Country:US
Practice Address - Phone:772-489-6800
Practice Address - Fax:772-461-6072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)