Organization
PCP LAKESHORE DRIVE OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETH WALKER (CFO, SRIM)
(850) 583-7990
Entity
Organization
Contact information
Practice address
2516 LAKESHORE DR, TALLAHASSEE, FL 32312-2104
(850) 616-6253
Mailing address
2573 BARRINGTON CIR, TALLAHASSEE, FL 32308-6805
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
Update your record
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