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Organization

LHI, LLC

Active
Other names
Lafayette Health Care Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD WISDAHL LNHA (ADMINISTRATOR)
(386) 294-3300
Entity
Organization

Contact information

Practice address
512 W MAIN ST, MAYO, FL 32066-4136
(386) 294-3300
(386) 294-3301
Mailing address
512 W MAIN ST, MAYO, FL 32066-4136
(386) 294-3300
(386) 294-3301

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF130470971
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
026448200
FL
01
35960908
STATE FACILITY MDS ID NUM
FL
Enumeration date
09/22/2005
Last updated
06/26/2008
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