Organization
LAKE PARKER FACILITY OPERATIONS LLC
Active
Other names
Consulate Health Care at Lake Parker
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization
Contact information
Practice address
2020 W LAKE PARKER DR, LAKELAND, FL 33805-5005
(863) 682-7580
(863) 683-9564
Mailing address
2020 W LAKE PARKER DR, LAKELAND, FL 33805-5005
(863) 682-7580
(863) 683-9564
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF10150962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008039300
—
FL
Enumeration date
07/25/2006
Last updated
11/27/2023
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