Provider Demographics
NPI:1780019992
Name:FLORIDA LIVING OPTIONS INC
Entity Type:Organization
Organization Name:FLORIDA LIVING OPTIONS INC
Other - Org Name:4TH FLORIDA LIVING OPTIONS LLC HAWTHORNE INN OF LAKELAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-679-7533
Mailing Address - Street 1:6150 LAKELAND HIGHLANDS RD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3850
Mailing Address - Country:US
Mailing Address - Phone:863-644-6414
Mailing Address - Fax:863-709-9301
Practice Address - Street 1:6150 LAKELAND HIGHLANDS RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3850
Practice Address - Country:US
Practice Address - Phone:863-644-6414
Practice Address - Fax:863-709-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9877310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL9877OtherASSISTED LIVING LICENSE