Organization
EAGLE LAKE OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN BICKY (MANAGER)
(914) 548-7617
Entity
Organization
Contact information
Practice address
1100 66TH ST N, ST PETERSBURG, FL 33710-6224
(914) 548-7617
Mailing address
1100 66TH ST N, ST PETERSBURG, FL 33710-6224
(914) 548-7617
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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