Provider Demographics
NPI:1710490966
Name:LAKELAND SNF INVESTORS LLC
Entity Type:Organization
Organization Name:LAKELAND SNF INVESTORS LLC
Other - Org Name:SCOTT LAKE HEALTH AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-386-2831
Mailing Address - Street 1:2123 CENTRE POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4930
Mailing Address - Country:US
Mailing Address - Phone:850-386-2831
Mailing Address - Fax:
Practice Address - Street 1:800 E COUNTY ROAD 540A
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-4650
Practice Address - Country:US
Practice Address - Phone:850-386-2831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT CARE II INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility