Organization
PRAM/LAKE MARY TE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS LYNN (EXECUTIVE DIRECTOR)
(407) 688-1660
Entity
Organization
Contact information
Practice address
3655 W LAKE MARY BLVD, LAKE MARY, FL 32746-3497
(407) 688-1660
Mailing address
3655 W LAKE MARY BLVD, LAKE MARY, FL 32746-3497
(407) 688-1660
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10007
FL
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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