Organization
LADY LAKE SNF LLC
Active
Other names
The Villages Rehabilitation and Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TZVI BOGOMILSKY (AUTHORIZED MEMBER)
(305) 401-7901
Entity
Organization
Contact information
Practice address
900 HIGHWAY 466, LADY LAKE, FL 32159
(352) 396-6956
Mailing address
1835 NE MIAMI GARDENS DR, #368, NORTH MIAMI BEACH, FL 33179-5035
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008104600
—
FL
Enumeration date
10/19/2012
Last updated
05/02/2014
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