Organization
1031CF LAKE CITY MT LLC
Active
Other names
The Canopy at Harper Lake
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD FERNANDEZ (MANAGER)
(844) 533-1031
Entity
Organization
Contact information
Practice address
213 NW GLEASON DR, LAKE CITY, FL 32055-5846
(386) 344-6985
(386) 438-5272
Mailing address
213 NW GLEASON DR, LAKE CITY, FL 32055-5846
(386) 344-6985
(386) 438-5272
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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