Provider Demographics
NPI:1609334259
Name:LS LAMPASAS OPERATOR II, LLC
Entity Type:Organization
Organization Name:LS LAMPASAS OPERATOR II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:WINTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-651-1808
Mailing Address - Street 1:1000 E AVENUE J
Mailing Address - Street 2:
Mailing Address - City:LAMPASAS
Mailing Address - State:TX
Mailing Address - Zip Code:76550-1211
Mailing Address - Country:US
Mailing Address - Phone:512-556-6267
Mailing Address - Fax:512-556-4428
Practice Address - Street 1:1000 E AVE J
Practice Address - Street 2:
Practice Address - City:LAMPASAS
Practice Address - State:TX
Practice Address - Zip Code:76550-1211
Practice Address - Country:US
Practice Address - Phone:512-556-6267
Practice Address - Fax:512-556-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-03
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility