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LAKE WALES SLC OPCO LLC NPI 1396482329


NPI Information

NPI: 1396482329
Provider Name: LAKE WALES SLC OPCO LLC

Doing Business As: THE CLUB AT LAKES WALES

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
12 E GROVE AVE
LAKE WALES, FL
ZIP 33853
Phone: (863) 679-8146
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LAKE WALES SLC OPCO LLC is an assisted living facility in Lake Wales, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. LAKE WALES SLC OPCO LLC NPI is 1396482329. The provider is registered as an organization entity type.
The provider Is Doing Business As The Club At Lakes Wales.

The provider's business location address is:

12 E GROVE AVE
LAKE WALES, FL
ZIP 33853-760
Phone: (863) 679-8146
Fax: (863) 422-0267

The provider's authorized official is Pilar Carvajal .
The authorized official title is Ceo and has the following contact phone number (305) 428-2480.

The enumeration date for this NPI number is 5/20/2022 and was last updated on 2/27/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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