Organization
LAKE WALES SLC OPCO LLC
Active
Other names
The Club at Lakes Wales
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PILAR CARVAJAL (CEO)
(305) 428-2480
Entity
Organization
Contact information
Practice address
12 E GROVE AVE, LAKE WALES, FL 33853-4760
(863) 679-8146
(863) 422-0267
Mailing address
941 W MORSE BLVD STE 100, WINTER PARK, FL 32789-3781
(305) 428-2480
(305) 428-2480
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/20/2022
Last updated
02/27/2023
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