Organization
CTK PROPERTIES, LLC
Active
Other names
Kiva of Mount Dora
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLY D LUCAS (MANAGING PARTNER)
(352) 383-5005
Entity
Organization
Contact information
Practice address
505 E 9TH AVE, MOUNT DORA, FL 32757-4937
(352) 383-5005
Mailing address
505 E 9TH AVE, MOUNT DORA, FL 32757-4937
(352) 383-5005
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL7959
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
689402000
—
FL
Enumeration date
06/24/2013
Last updated
06/24/2013
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