Provider Demographics
NPI:1568107258
Name:SOUTHERN LIFE OPERATING INVESTMENTS LLC
Entity Type:Organization
Organization Name:SOUTHERN LIFE OPERATING INVESTMENTS LLC
Other - Org Name:SOUTHERN LIFESTYLES SENIOR LIVING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-753-5107
Mailing Address - Street 1:1297 US 27 N
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-7907
Mailing Address - Country:US
Mailing Address - Phone:863-465-0568
Mailing Address - Fax:
Practice Address - Street 1:1297 US 27 N
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:FL
Practice Address - Zip Code:33852-7907
Practice Address - Country:US
Practice Address - Phone:863-465-0568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility