Organization
SA-LAKELAND, LLC
Active
Other names
Palm Terrace of Lakeland
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX PALEY (COO)
(914) 390-4363
Entity
Organization
Contact information
Practice address
1919 LAKELAND HILLS BLVD, LAKELAND, FL 33805-2901
(863) 688-5612
(863) 687-8870
Mailing address
1919 LAKELAND HILLS BLVD, LAKELAND, FL 33805-2901
(863) 688-5612
(863) 688-1398
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF14530961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028262600
—
FL
Enumeration date
06/22/2005
Last updated
05/02/2014
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