Organization
BLUE LAKE POST ACUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT H TANNER (LEGAL COUNSEL)
(949) 430-5178
Entity
Organization
Contact information
Practice address
991 E NEW YORK AVE, DELAND, FL 32724-5664
(386) 734-9083
Mailing address
991 E NEW YORK AVE, DELAND, FL 32724-5664
(386) 734-9083
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/25/2022
Last updated
01/19/2023
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