Organization
LUBIS ENTERPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVIANO LUBIS (OWNER)
(352) 787-3034
Entity
Organization
Contact information
Practice address
39106 GRAYS AIRPORT RD, LADY LAKE, FL 32159-4004
(352) 750-9150
Mailing address
39106 GRAYS AIRPORT RD, LADY LAKE, FL 32159-4004
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/11/2020
Last updated
05/11/2020
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