Organization
BLC TAVARES-GC,LLC
Active
Other names
Brookdale Lake Tavares
Organization subpart
No
Provider details
NPI number
Authorized official
MARK OHLENDORF (CO-PRESIDENT)
(414) 918-5000
Entity
Organization
Contact information
Practice address
1211 E CAROLINE ST, TAVARES, FL 32778-3460
(353) 343-6464
(352) 343-2909
Mailing address
111 WESTWOOD PL, SUITE 400, BRENTWOOD, TN 37027-5021
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/17/2010
Last updated
10/19/2015
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