# LAKELAND COMMUNITY HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700658150
- **Authorized official:** MS. KURSULA KIRBY (CEO)
- **Authorized official phone:** (863) 617-2314

## Contact information

- **Practice address:** 122 E MAIN ST, LAKELAND, FL 33801-4655
- **Practice address phone:** (863) 617-2314
- **Mailing address:** 122 E MAIN ST \# 111, LAKELAND, FL 33801-4655
- **Mailing address phone:** (863) 617-2315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133N00000X | Nutritionist | — | NULL | — |
| 133N00000X | Nutritionist | — | — | — |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | Yes |
| 133NN1002X | Nutrition Education Nutritionist | — | — | Yes |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |
| 172V00000X | Community Health Worker | — | NULL | — |
| 172V00000X | Community Health Worker | — | — | — |
| 174H00000X | Health Educator | — | NULL | — |
| 174H00000X | Health Educator | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | — |
| 251K00000X | Public Health or Welfare Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | — |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 10/27/2023
- **Last updated:** 10/27/2023