Organization
SENIOR CARE GROUP, INC
Active
Other names
Lakeshore Villas Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE CHUDOW (CHIEF FINANCIAL OFFICER)
(813) 341-2735
Entity
Organization
Contact information
Practice address
16002 LAKESHORE VILLA DRIVE, TAMPA, FL 33613-1367
(813) 968-5093
(813) 264-0476
Mailing address
16002 LAKESHORE VILLA DRIVE, TAMPA, FL 33613-1367
(813) 968-5093
(813) 264-0476
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
SNF1282096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021805700
—
FL
Enumeration date
05/31/2006
Last updated
11/21/2011
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