Organization
LAKE WALES OPERATING GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANSHEL NIEDERMAN (MANAGER)
(929) 900-2005
Entity
Organization
Contact information
Practice address
730 N SCENIC HWY, LAKE WALES, FL 33853-3208
(863) 676-1512
Mailing address
544 PARK AVE STE B04, BROOKLYN, NY 11205-1670
(917) 682-3129
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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