Provider Demographics
NPI:1932332814
Name:LAKELAND COMMUNITY HEALTH AND REHABILITATION
Entity Type:Organization
Organization Name:LAKELAND COMMUNITY HEALTH AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-682-4700
Mailing Address - Street 1:200 PARKVIEW PL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4548
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 PARKVIEW PL
Practice Address - Street 2:SUITE 201
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4548
Practice Address - Country:US
Practice Address - Phone:863-682-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization