Organization
NIC 5 LAKE MORTON PLAZA LEASING LLC
Active
Other names
Lake Morton Plaza
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANE RYU (PRESIDENT/CEO/CFO)
(212) 479-5270
Entity
Organization
Contact information
Practice address
400 S FLORIDA AVE, LAKELAND, FL 33801
(863) 683-1000
(863) 682-7854
Mailing address
PO BOX 1700 C/O HOLIDAY RETIREMENT, NIC 5 LAKE MORTON PLAZA LEASING LLC, LAKE OSWEGO, OR 97035
(971) 245-8020
(503) 431-2295
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5308
FL
Other
Enumeration date
04/29/2013
Last updated
11/30/2016
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