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Organization
VILLAGE VERANDA AT LADY LAKE, LLC
Active
Organization
VILLAGE VERANDA AT LADY LAKE, LLC
Active
Other names
VILLAGE VERANDA AT LADY LAKE
Organization subpart
No
Provider details
NPI number
Authorized official
SETH WALKER (CFO)
(850) 583-7990
Entity
Organization
Contact information
Practice address
955 S US HIGHWAY 441, LADY LAKE, FL 32159-5208
(352) 751-5494
Mailing address
2573 BARRINGTON CIR, TALLAHASSEE, FL 32308-6805
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104709300
—
FL
01
—
13312
AHCA ALF LICENSE
FL
Enumeration date
12/05/2019
Last updated
02/26/2020
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